Physical treatment interventions for managing spasticity after stroke

Monaghan, Kenneth; Horgan, Frances; Blake, Catherine; Cornall, Catherine; Hickey, P; Lyons, Bernadette E; Langhorne, Peter

doi:10.1002/14651858.cd009188.pub2

Cited by 19 publications

(14 citation statements)

References 72 publications

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“…Stretching exercise is effective in reducing spasticity because it increases the expansibility of the tissues [6202122]. However, conventional exercise treatment might be less efficient or patients might not concentrate on the treatment and have a negative awareness because the same motion is induced for a long time by the therapist [2324].…”

Section: Discussionmentioning

confidence: 99%

Effect of Upper Extremity Robot-Assisted Exercise on Spasticity in Stroke Patients

et al. 2016

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ObjectiveTo determine the efficacy of a stretching and strengthening exercise program using an upper extremity robot, as compared with a conventional occupational therapy program for upper extremity spasticity in stroke patients.MethodsSubjects were randomly divided into a robot-assisted therapy (RT) group and a conventional rehabilitation therapy (CT) group. RT group patients received RT and CT once daily for 30 minutes each, 5 days a week, for 2 weeks. RT was performed using an upper-extremity robot (Neuro-X; Apsun Inc., Seoul, Korea), and CT was administered by occupational therapists. CT group patients received CT alone twice daily for 30 minutes, 5 days a week, for 2 weeks. Modified Ashworth Scale (MAS) was used to measure the spasticity of upper extremity. Manual muscle tests (MMT), Manual Function Tests (MFT), Brunnstrom stage, and the Korean version of Modified Barthel Index (K-MBI) were used to measure the strength and function of upper extremity. All measurements were obtained before and after 2-week treatment.ResultsThe RT and CT groups included 22 subjects each. After treatment, both groups showed significantly lower MAS scores and significant improvement in the MMT, MFT, Brunnstrom stage, and K-MBI scores. Treatment effects showed no significant differences between the two groups.ConclusionRT showed similar treatment benefits on spasticity, as compared to CT. The study results suggested that RT could be a useful method for continuous, repeatable, and relatively accurate range of motion exercise in stroke patients with spasticity.

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Section: Discussionmentioning

confidence: 99%

Effect of Upper Extremity Robot-Assisted Exercise on Spasticity in Stroke Patients

et al. 2016

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“…Comments, reviews, observational studies, books, poster/oral abstract communications, case reports, pre-post studies, systematic reviews and practice guidelines were excluded. We defined conventional physiotherapy as physical treatment interventions to reduce spasticity based on the review by Monaghan et al 9 The primary outcome was upper limb spasticity and functionality, although additional outcomes measured before and at any time following extracorporeal shock wave intervention were also used.…”

Section: Methodsmentioning

confidence: 99%

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

et al. 2020

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Objective: To assess the effectiveness of Extracorporeal Shock Wave Therapy for reducing spasticity and improving functionality of the upper limb in stroke survivors. Data sources: A systematic review of MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, PEDro, REHABDATA, Scielo, Scopus, Web of Science, Tripdatabase and Epistemonikos from 1980 to April 2020 was carried out. Review methods: The bibliography was screened to identify randomized controlled clinical trials that applied extracorporeal shock waves to upper limb spastic muscles in post-stroke individuals. Two reviewers independently screened references, selected relevant studies, extracted data and assessed risk of bias using the PEDro scale. The primary outcome was spasticity and functionality of the upper limb. Results: A total of 1,103 studies were identified and 16 randomized controlled trials were finally included (764 individuals) were analyzed. A meta-analysis was performed and a beneficial effect on spasticity was found. The mean difference (MD) on the Modified Ashworth Scale for comparison extracorporeal shock wave versus sham was −0.28; with a 95% confidence interval (CI) from −0.54 to −0.03. The MD of the comparison of extracorporeal shock wave plus conventional physiotherapy versus conventional physiotherapy was −1.78; 95% CI from −2.02 to −1.53. The MD for upper limb motor-function using the Fugl Meyer Assessment was 0.94; 95% CI from 0.42 to 1.47 in the short term and 0.97; 95% CI from 0.19 to 1.74 in the medium term. Conclusion: The extracorporeal shock wave therapy is effective for reducing upper limb spasticity. Adding it to conventional therapy provides an additional benefit.

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“…Informal caregivers are defined as those who provide unpaid assistance to others, usually a family member or friend, following onset of chronic illness or disability . According to the Irish National Audit of Stroke Care (INASC), there are approximately 30,000 stroke survivors in Ireland, many of whom required the support of informal caregivers to carry out their daily activities .The support required can be extensive and demanding as stroke often leads to physical, cognitive, and psychological deficits in survivors .…”

Section: Introductionmentioning

confidence: 99%

Implications of Stroke for Caregiver Outcomes: Findings from the ASPIRE-S Study

Atteih

Mellon

Hall

et al. 2015

International Journal of Stroke

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on behalf of the ASPIRE-S study group Background Informal caregivers are vital to the long-term care and rehabilitation of stroke survivors worldwide. However, caregiving has been associated with negative psychological outcomes such as anxiety and depression, which leads to concerns about caregiver as well as stroke survivor well-being. Furthermore, caregivers may not receive the support and service provision they require from the hospitals and community. Aims This study examines caregiver psychological well-being and satisfaction with service provision in the context of stroke. Methods Caregiver data were collected as part of the ASPIRE-S study, a prospective study of secondary prevention and rehabilitation which assessed stroke patients and their carers at six-months post stroke. Carer assessment included measurement of demographics, satisfaction with care (UK Healthcare Commission National Patient Survey of Stroke Care), psychological distress (Hospital Anxiety and Depression Scale), and vulnerability (Vulnerable Elders Scale). Logistic regression analyses and chi-squared tests were performed using STATA version 12. Results Analyses from 162 carers showed substantial levels of dissatisfaction (37·9%) with community and hospital services, as well as notable levels of anxiety (31·3%) and depressive symptoms (18·8%) among caregivers. Caregiver anxiety was predicted by stroke survivor anxiety (OR = 3·47, 95% CI 1·35-8·93), depression (OR = 5·17, 95% CI 1·83-14·58), and stroke survivor cognitive impairment (OR 2·35, 95% CI 1·00-5·31). Caregiver depression was predicted by stroke survivor anxiety (OR = 4·41, 95% CI 1·53-12·72) and stroke survivor depression (OR = 6·91, 95% CI 2·26-21·17). Conclusion Findings indicate that caregiver and stroke survivor well-being are interdependent. Thus, early interventions, including increased training and support programs that include caregivers, are likely to reduce the risk of negative emotional outcomes.

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Physical treatment interventions for managing spasticity after stroke

Cited by 19 publications

References 72 publications

Effect of Upper Extremity Robot-Assisted Exercise on Spasticity in Stroke Patients

Effect of Upper Extremity Robot-Assisted Exercise on Spasticity in Stroke Patients

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

Implications of Stroke for Caregiver Outcomes: Findings from the ASPIRE-S Study

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