Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews / Fary Khan in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)  

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 265-273 Titre : Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews Type de document : texte imprimé Auteurs : Fary Khan ; Bhasker Amatya ; D. Bensmail ; Alain P. Yelnik Année de publication : 2019 Article en page(s) : p. 265-273 Note générale : doi.org/10.1016/j.rehab.2017.10.001 Langues : Anglais (eng) Mots-clés : Spasticity  Non-pharmacological intervention  Rehabilitation  Disability  Impairment  Participation Résumé : Objectives Spasticity causes significant long-term disability-burden, requiring comprehensive management. This review evaluates evidence from published systematic reviews of clinical trials for effectiveness of non-pharmacological interventions for improved spasticity outcomes. Methods Data sources: a literature search was conducted using medical and health science electronic (MEDLINE, EMBASE, CINAHL, PubMed, and the Cochrane Library) databases for published systematic reviews up to 15th June 2017. Data extraction and synthesis: two reviewers applied inclusion criteria to select potential systematic reviews, independently extracted data for methodological quality using Assessment of Multiple Systematic Reviews (AMSTAR). Quality of evidence was critically appraised with Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results Overall 18 systematic reviews were evaluated for evidence for a range of non-pharmacological interventions currently used in managing spasticity in various neurological conditions. There is “moderate” evidence for electro-neuromuscular stimulation and acupuncture as an adjunct therapy to conventional routine care (pharmacological and rehabilitation) in persons following stroke. “Low” quality evidence for rehabilitation programs targeting spasticity (such as induced movement therapy, stretching, dynamic elbow-splinting, occupational therapy) in stroke and other neurological conditions; extracorporeal shock-wave therapy in brain injury; transcranial direct current stimulation in stroke; transcranial magnetic stimulation and transcutaneous electrical nerve stimulation for other neurological conditions; physical activity programs and repetitive magnetic stimulation in persons with MS, vibration therapy for SCI and stretching for other neurological condition. For other interventions, evidence was inconclusive. Conclusions Despite the available range of non-pharmacological interventions for spasticity, there is lack of high-quality evidence for many modalities. Further research is needed to judge the effect with appropriate study designs, timing and intensity of modalities, and associate costs of these interventions. En ligne : https://www.sciencedirect.com/science/article/pii/S1877065717304153 Permalink : ./index.php?lvl=notice_display&id=84131 [article] Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews [texte imprimé] / Fary Khan ; Bhasker Amatya ; D. Bensmail ; Alain P. Yelnik . - 2019 . - p. 265-273. doi.org/10.1016/j.rehab.2017.10.001 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 265-273 Mots-clés : Spasticity  Non-pharmacological intervention  Rehabilitation  Disability  Impairment  Participation Résumé : Objectives Spasticity causes significant long-term disability-burden, requiring comprehensive management. This review evaluates evidence from published systematic reviews of clinical trials for effectiveness of non-pharmacological interventions for improved spasticity outcomes. Methods Data sources: a literature search was conducted using medical and health science electronic (MEDLINE, EMBASE, CINAHL, PubMed, and the Cochrane Library) databases for published systematic reviews up to 15th June 2017. Data extraction and synthesis: two reviewers applied inclusion criteria to select potential systematic reviews, independently extracted data for methodological quality using Assessment of Multiple Systematic Reviews (AMSTAR). Quality of evidence was critically appraised with Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results Overall 18 systematic reviews were evaluated for evidence for a range of non-pharmacological interventions currently used in managing spasticity in various neurological conditions. There is “moderate” evidence for electro-neuromuscular stimulation and acupuncture as an adjunct therapy to conventional routine care (pharmacological and rehabilitation) in persons following stroke. “Low” quality evidence for rehabilitation programs targeting spasticity (such as induced movement therapy, stretching, dynamic elbow-splinting, occupational therapy) in stroke and other neurological conditions; extracorporeal shock-wave therapy in brain injury; transcranial direct current stimulation in stroke; transcranial magnetic stimulation and transcutaneous electrical nerve stimulation for other neurological conditions; physical activity programs and repetitive magnetic stimulation in persons with MS, vibration therapy for SCI and stretching for other neurological condition. For other interventions, evidence was inconclusive. Conclusions Despite the available range of non-pharmacological interventions for spasticity, there is lack of high-quality evidence for many modalities. Further research is needed to judge the effect with appropriate study designs, timing and intensity of modalities, and associate costs of these interventions. En ligne : https://www.sciencedirect.com/science/article/pii/S1877065717304153 Permalink : ./index.php?lvl=notice_display&id=84131

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