Effectiveness of Stretching in Post-Stroke Spasticity and Range of Motion: Systematic Review and Meta-Analysis

Abstract

Spasticity is one of the most frequent and disabling clinical manifestations of patients with stroke. In clinical practice, stretching is the most widely used physiotherapeutic intervention for this population. However, there is no solid evidence for its effectiveness. The aim of this study was to evaluate the effectiveness of different types of stretching in reducing post-stroke spasticity. Research was carried out until March 2021 in the following scientific databases: PubMed, CINAHL, Scopus, Cochrane Library, Web of Science, and PEDro. The PEDro scale and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Eight articles were selected for qualitative analysis; six of them contributed information to the meta-analysis. No conclusive evidence was obtained on the effectiveness of stretching in terms of treating spasticity and range of motion in patients with stroke. Further research is necessary in order to determine the effectiveness of the use of stretching in this population, considering the different types of stretching (static and dynamic), the time of application, the measurement of the different components of spasticity, and the extrapolation of functional results.

Virtual Reality and Physiotherapy in Post-Stroke Functional Re-Education of the Lower Extremity: A Controlled Clinical Trial on a New Approach

“…The CP programme focused on 1 h/day of overall functional recovery of the patient (including the upper limb), based on mixed techniques with different approaches [57][58][59][60]. Patients assigned to the CP group received 1 more hour of specific LE rehabilitation consisting of stretching [61,62], passive, assisted, and active exercises in many directions in The CP programme focused on 1 h/day of overall functional recovery of the patient (including the upper limb), based on mixed techniques with different approaches [57][58][59][60]. Patients assigned to the CP group received 1 more hour of specific LE rehabilitation consisting of stretching [61,62], passive, assisted, and active exercises in many directions in the lower extremity working space (e.g., hip joint flexion and extension, abduction and adduction, rotation internal and external, knee flexion, and extension).…”

Personalized Approaches to Stroke: One Step Forward for Functional Recovery of Stroke Patients

“…Stretching has been most widely used in the physical management of post-stroke spasticity [ 8 ]. However, no conclusive evidence was analyzed on the effectiveness of stretching for post-stroke spasticity [ 9 ]. This meta-analysis proposed an individual stretching method based on stroke patients’ characteristics [ 9 ].…”

“…However, no conclusive evidence was analyzed on the effectiveness of stretching for post-stroke spasticity [ 9 ]. This meta-analysis proposed an individual stretching method based on stroke patients’ characteristics [ 9 ]. Zhang et al [ 10 ] reported that endovascular coil embolization for aneurysmal subarachnoid hemorrhage (SAH) showed a higher risk than surgical clipping.…”

“…Personalized medicine is a growing field in diagnosing, managing and predicting stroke and will enable clinicians to develop individually tailored care plans for stroke patients [ 3 , 6 , 7 , 22 ]. All papers published in this Special Issue will be able to contribute to the advance of personalized medicine in strokes [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. The objective of this editorial is to stimulate any research on personalized medicine for the evaluation and treatment of stroke patients.…”

“…However, there are still many hurdles to overcome to reach personalized medicine for stroke patients. Through the papers published in this Special Issue [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], it was found that a number of factors must be considered, and a new and diverse approach was also required for personalized medicine. Therefore, a multidisciplinary approach and research are strongly encouraged for the personalized medicine of stroke treatment and rehabilitation.…”