Immediate changes in standing and walking when placing a hanger around the head of a patient with body lateropulsion: a case report

Physiother Theory Pract. 2025 Jan 17:1-7. doi: 10.1080/09593985.2025.2452902. Online ahead of print.

Abstract

Introduction: Body lateropulsion is a postural disorder characterized by involuntary leaning to one side and is a major symptom in individuals with Wallenberg syndrome. Although the hanger reflex has potential applications as a simple stimulus to control posture, there are no reports of its use in body lateropulsion cases. The case report aims to document the immediate effects of a wire hanger worn around the head on the center of foot pressure and gait pattern parameters.

Case description: The patient, a man in his 50s, exhibited no motor paralysis of the upper and lower extremities following the onset of stroke but demonstrated left lateropulsion. Assessments of center of pressure (COP) during standing, as well as evaluating spatiotemporal and kinematic factors through three-dimensional gait analysis, both with and without a hanger worn around the head.

Outcomes: The application of the hanger to the patient's head resulted in immediate improvements in postural control and walking ability. When the hanger was placed around the head, compared with the non-hanger condition, the deviation of the COP toward the lateropulsion side during the standing trial improved immediately. Additionally, placement of a hanger around the head increased hip adduction range of motion during the stance phase, decreased step width, and increased gait speed.

Discussion: This case report suggests the need for further research regarding the effect and efficacy of a hanger worn around the head as a tool for understanding the pathophysiology of body lateropulsion and for providing enhancements in both standing posture and walking ability.

Keywords: Lateropulsion; center of pressure; gait analysis; hanger.