Abstract Of The WEEK

To submit an "Abstract Of The Week" to the NPTA, please click here to fill out the form. If selected, your entry will be pubished on the NPTA blog. 

Many more abstracts can be found at PubMed or by clicking here. 

Blog

Abstract of the Week For 11/12/17: Spasticity after spinal cord injury: an evidence-based review of current interventions.

Abstract

Spasticity After Spinal Cord Injury: An Evidence-Based Review of Current Interventions
Hsieh 1Wolfe 2Connolly 3Townson 4Curt 5Blackmer 6Sequeira 7Aubut 8

 

1 Aging Rehabilitation and Geriatric Care, Lawson Health Research Institute, London, Ontario, Canada

2 Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care, and the Schulich School of Medicine. Department of Physical Medicine and Rehabilitation, University of Western Ontario, St. Joseph’s Health Care London, Parkwood Hospital, London, Ontario, Canada

3 St. Joseph’s Health Care London, Parkwood Hospital, London, Ontario, Canada.

4 Division of Physical Medicine and Rehabilitation; Medical Manager SCI Rehab Program at GF Strong Rehabilitation Centre; and Investigator, ICORD (International Collaboration on Repair Discoveries), University of British Columbia, Vancouver, British Columbia, Canada.

5 University of British Columbia, Vancouver, British Columbia, Canada.

6 Ottawa Hospital Rehabilitation Centre, Department of Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, Ontario, Canada.

7 Parkwood Hospital, St. Joseph’s Health Care. Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada.

8 Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, London, Ontario, Canada.

Purpose: To provide an overview of evidence for spinal cord injury (SCI) spasticity interventions in peerreviewed, published literature. 

Method: Structured review and synthesis of spasticity treatments in the literature. Each publication was rated according to the Downs and Black methodology for assessing nonrandomized studies and according to the Physiotherapy Evidence Database (PEDro) scale for assessing randomized controlled trials. 

Results: Level 1 evidence supports the use of transcutaneous electrical nerve stimulation (TENS), penile vibration, baclofen, tizanidine, clonidine, cyproheptadine, gabapentin, and Lthreonine to reduce spasticity in SCI. 

Conclusion: Although spasticity is a common complication following SCI, there is relatively little evidence for the treatment of spasticity and even less evidence that has been confirmed by independent replication. TENS is the only routine nonpharmacological treatment for spasticity that is supported by adequate level 1 evidence. Several pharmacological treatments, including baclofen, tizanidine, and clonidine, are supported by level 1 evidence. There is level 1 evidence to support test doses of intrathecal baclofen for the short-term reduction of spasticity in SCI but not for its long-term use. The lack of level 1 evidence for spasticity interventions does not necessarily reflect a lack of effective treatments, but it does emphasize the need for further studies. All other interventions reviewed would benefit from further study.

PMID: none
To read the full abstract, click here.

This Abstract was submitted by Jacquelyn Machado PT, DPT, Creighton University Neurologic PT Resident; jacquelynmachado@creighton.edu.

Return to list

0 Comments