Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews

Khan, Fary; Amatya, Bhasker; Bensmaïl, Djamel; Yelnik, A.

doi:10.1016/j.rehab.2017.10.001

Cited by 92 publications

(61 citation statements)

References 45 publications

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“…). The results of this review agree with the findings of other reviews which also conclude that there is a lack of high quality evidence for many modalities of treatment of spasticity (Khan, Amatya, Bensmail, & Yelnik, 2017).…”

Section: What Are the Implications Of The Cochrane Evidence For Practsupporting

confidence: 87%

Which interventions are useful for managing muscle spasticity in individuals who sustained traumatic brain injury? – A Cochrane Review summary with commentary

Laxe

2019

NRE

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BACKGROUND: Spasticity is a frequent symptom after traumatic brain injury. OBJECTIVE: To assess the effects of different interventions used for muscle spasticity after TBI. METHODS: To summarize a rehabilitation perspective "Cochrane Review" conducted by Synnot et al. RESULTS: Nine studies were involved for the Cochrane review. Poor report on the results of the studies that tested the effectiveness of interventions in spasticity are responsible for the low quality of the evidence. Most of the studies reported results in terms of decreasing spasticity and limiting effects in terms of how the decrease spasticity and no reports on the beneficial effects in terms of improving activities and participation. CONCLUSIONS: High quality adequately powered trials in patients with TBI should be encouraged.

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Section: What Are the Implications Of The Cochrane Evidence For Practsupporting

confidence: 87%

Which interventions are useful for managing muscle spasticity in individuals who sustained traumatic brain injury? – A Cochrane Review summary with commentary

Laxe

2019

NRE

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“…The therapeutic effect or mechanism of action of EA for myotonia in DM1 has not been reported. However, EA is widely used as a non-pharmacological intervention for spasticity, [ 16 ] and EA is known to affect muscle hyper-excitability. In a previous post-stroke spasticity study, acupuncture increased the mean H-reflex recovery time within the antagonistic muscle of the spastic muscle.…”

Section: Discussionmentioning

confidence: 99%

Improved grip myotonia in a patient with myotonic dystrophy type 1 following electroacupuncture therapy

2020

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“…A variety of pharmacological and non-pharmacological treatments are available for the control of severe spasticity[ 9 ]. However, there is no high-quality evidence for non-pharmacological treatments; hence, pharmacological treatment is favored over non-pharmacological treatment[ 9 , 10 ]. Oral baclofen is generally recommended as first line treatment for spasticity in individuals with SCI[ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, there is no high-quality evidence for non-pharmacological treatments; hence, pharmacological treatment is favored over non-pharmacological treatment[ 9 , 10 ]. Oral baclofen is generally recommended as first line treatment for spasticity in individuals with SCI[ 9 , 10 ]. However, the relatively high oral doses of baclofen have been associated with undesirable side effects such as dizziness, fatigue, liver toxicity and excessive sedation, which can impair problem solving and intellectual judgement[ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term effect of intrathecal baclofen treatment on bone health and body composition after spinal cord injury: A case matched report

Ifon¹,

Ghatas²,

Davis³

et al. 2020

WJO

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BACKGROUND Severe spasticity may negatively impact functionality and quality of life after spinal cord injury (SCI). Intrathecal baclofen treatment (IBT) is effectively used to manage severe spasticity and reduce comorbidities. However, long-term IBT may have a negative effect on bone mineral content (BMC), bone mineral density (BMD) and body composition (such as percentage fat mass and lean body mass). We demonstrated the negative effects of long-term IBT use in a single case compared with two non-IBT users. CASE SUMMARY A 46-year old Caucasian male Veteran (case) with a 21 year history of complete tetraplegia (complete C6 SCI) was implanted with IBT for 20 years. The case was matched to two participants with different time since injuries [2 (match 1) and 13 (match 2) years] without IBT. Knee BMC and BMD at the epiphysis and metaphysis of the distal femur and proximal tibia were evaluated using dual knee and the dual femur modules of GE Lunar iDXA software. Total and leg body composition assessments were also conducted for the three participants. Potential effect of long-term IBT was demonstrated by changes in BMD, consistent with bone demineralization, at the distal femur and proximal tibia and changes in percentage fat mass and lean mass of legs. The case showed 113% lower BMD at the distal femur, and 78.1% lower at the proximal tibia compared to match 1, moreover the case showed 45% lower BMD at the distal femur, and no observed changes at the proximal tibia compared to match 2. The case had 27.1% and 16.5% greater leg %fat mass compared to match 1 and match 2, respectively. Furthermore, the case had 17.4% and 11.8% lower % leg lean mass compared to match 1 and match 2, respectively. CONCLUSION Long-term IBT may impact bone health and body composition parameters in persons with complete SCI. It may be prudent to encourage regular screening of individuals on long-term IBT considering the prevalence of osteoporosis related fractures, cardiovascular diseases, and metabolic disorders in this population.

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Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews

Cited by 92 publications

References 45 publications

Which interventions are useful for managing muscle spasticity in individuals who sustained traumatic brain injury? – A Cochrane Review summary with commentary

Which interventions are useful for managing muscle spasticity in individuals who sustained traumatic brain injury? – A Cochrane Review summary with commentary

Improved grip myotonia in a patient with myotonic dystrophy type 1 following electroacupuncture therapy

Long-term effect of intrathecal baclofen treatment on bone health and body composition after spinal cord injury: A case matched report

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