Lisa A Harvey1, Owen M Katalinic1, Robert D Herbert2, Anne M Moseley3, Natasha A Lannin4, Karl Schurr5. 1. John Walsh Centre for Rehabilitation Research, Northern Clinical School, Sydney School of Medicine, University of Sydney. 2. Neuroscience Research Australia. 3. The George Institute for Global Health, Sydney Medical School, University of Sydney. 4. School of Allied Health, Department of Community and Clinical Allied Health, Occupational Therapy, College of Science, Health and Engineering, La Trobe University, Melbourne. 5. Physiotherapy Consultant, Sydney, Australia.
Abstract
QUESTION: Is stretch effective for the treatment and prevention of contractures in people with neurological and non-neurological conditions? DESIGN: A Cochrane Systematic Review with meta-analyses of randomised trials. PARTICIPANTS: People with or at risk of contractures. INTERVENTION: Trials were considered for inclusion if they compared stretch to no stretch, or stretch plus co-intervention to co-intervention only. The stretch could be administered in any way. OUTCOME MEASURES: The outcome of interest was joint mobility. Two sets of meta-analyses were conducted with a random-effects model: one for people with neurological conditions and the other for people with non-neurological conditions. The quality of evidence supporting the results of the two sets of meta-analyses was assessed using GRADE. RESULTS: Eighteen studies involving 549 participants examined the effectiveness of stretch in people with neurological conditions, and provided useable data. The pooled mean difference was 2 deg (95% CI 0 to 3) favouring stretch. This was equivalent to a relative change of 2% (95% CI 0 to 3). Eighteen studies involving 865 participants examined the effectiveness of stretch in people with non-neurological conditions, and provided useable data. The pooled standardised mean difference was 0.2 SD (95% CI 0 to 0.3) favouring stretch. This translated to an absolute mean increase of 1 deg (95% CI 0 to 2) and a relative change of 1% (95% CI 0 to 2). The GRADE level of evidence was high for both sets of meta-analyses. CONCLUSION: Stretch does not have clinically important effects on joint mobility. [Harvey LA, Katalinic OM, Herbert RD, Moseley AM, Lannin NA, Schurr K (2017) Stretch for the treatment and prevention of contracture: an abridged republication of a Cochrane Systematic Review. Journal of Physiotherapy 63: 67-75].
QUESTION: Is stretch effective for the treatment and prevention of contractures in people with neurological and non-neurological conditions? DESIGN: A Cochrane Systematic Review with meta-analyses of randomised trials. PARTICIPANTS: People with or at risk of contractures. INTERVENTION: Trials were considered for inclusion if they compared stretch to no stretch, or stretch plus co-intervention to co-intervention only. The stretch could be administered in any way. OUTCOME MEASURES: The outcome of interest was joint mobility. Two sets of meta-analyses were conducted with a random-effects model: one for people with neurological conditions and the other for people with non-neurological conditions. The quality of evidence supporting the results of the two sets of meta-analyses was assessed using GRADE. RESULTS: Eighteen studies involving 549 participants examined the effectiveness of stretch in people with neurological conditions, and provided useable data. The pooled mean difference was 2 deg (95% CI 0 to 3) favouring stretch. This was equivalent to a relative change of 2% (95% CI 0 to 3). Eighteen studies involving 865 participants examined the effectiveness of stretch in people with non-neurological conditions, and provided useable data. The pooled standardised mean difference was 0.2 SD (95% CI 0 to 0.3) favouring stretch. This translated to an absolute mean increase of 1 deg (95% CI 0 to 2) and a relative change of 1% (95% CI 0 to 2). The GRADE level of evidence was high for both sets of meta-analyses. CONCLUSION: Stretch does not have clinically important effects on joint mobility. [Harvey LA, Katalinic OM, Herbert RD, Moseley AM, Lannin NA, Schurr K (2017) Stretch for the treatment and prevention of contracture: an abridged republication of a Cochrane Systematic Review. Journal of Physiotherapy 63: 67-75].
Authors: Pedro Valadão; Harri Piitulainen; Eero A Haapala; Tiina Parviainen; Janne Avela; Taija Finni Journal: BMC Sports Sci Med Rehabil Date: 2021-02-26
Authors: Anastasia V Keller; Kathlene M Rees; Erik J Seibt; B Danni Wood; Abigail D Wade; Johnny Morehouse; Alice Shum-Siu; David S K Magnuson Journal: Spinal Cord Date: 2018-02-19 Impact factor: 2.772