Validation and Distribution Characteristics of the Grading of Lateropulsion in Patients with Infratentorial Stroke: A Preliminary Study.

Objectives: Body lateropulsion (BL) is a postural orientation disorder after stroke, characterized by an involuntary tilt of the body to one side. We aimed to evaluate the validity of the Grading of Lateropulsion (GoL)-a measure of BL severity-by examining its associations with balance, ataxia, and walking ability in patients with infratentorial stroke. We also assessed the distribution characteristics of GoL scores. Methods: We evaluated 21 patients with infratentorial stroke who presented with BL using the Berg Balance Scale (BBS), subjective visual vertical, Scale for the Assessment and Rating of Ataxia (SARA), and Functional Ambulation Category (FAC). We then analyzed the correlations between these measures and GoL. We also calculated the proportions of patients with the lowest and highest GoL scores. In patients who completed the 1-month follow-up, FAC scores were compared between baseline and follow-up. Results: Significant correlations with GoL were observed for BBS, SARA, and FAC. GoL Grade 1 was observed in 57.1% of the patients and Grade 4 in 28.6%, suggesting the presence of both floor and ceiling effects. The median FAC score increased from 4 at baseline to 5 at follow-up, demonstrating a significant improvement. Conclusions: GoL severity was strongly associated with ataxia, balance function, and walking independence, indicating a complex and multifactorial pathophysiology of BL. However, notable floor and ceiling effects as well as the negatively skewed distribution of GoL scores indicated limited sensitivity for detecting subtle changes in BL severity.