Lisa Tedesco Triccas1, Niamh Kennedy2, Toby Smith3, Valerie Pomeroy4. 1. Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Heverlee, Belgium; School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK. Electronic address: lisa.tedescotriccas@kuleuven.be. 2. School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK; School of Psychology, Ulster University, Cromore Road, Coleraine Co. Londonderry, Ulster, BT52 1SA UK. Electronic address: n.kennedy@ulster.ac.uk. 3. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK. Electronic address: toby.smith@ndorms.ox.ac.uk. 4. School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK. Electronic address: V.Pomeroy@uea.ac.uk.
Abstract
OBJECTIVE: To determine the predictive markers for the occurrence of upper limb spasticity in the first 12 months after stroke. DATA SOURCES: A systematic review was undertaken of the databases MEDLINE, EMBASE, CINAHL and PEDRO to 31st December 2017. STUDY SELECTION: Non-experimental or experimental studies that included a control group with spasticity who did not receive an experimental intervention which investigated at least one variable (explanatory variable) measured at baseline against the development (or not) of spasticity at a future time point within 12 months post stroke were selected independently by two reviewers. Eleven papers met the selection criteria. STUDY APPRAISAL: Data were extracted into tabular format using predefined data fields by two reviewers. Study quality was evaluated using the modified Downs and Black tool. Data were analysed using a meta-analysis or narrative review. RESULTS: Ten studies, including 856 participants were analysed. The predictive markers of upper limb spasticity at one month post stroke were: motor 11.25 (odds ratio, OR); [95% CI:2.48, 51.04] and sensory impairments 4.91 (OR); [1.24, 19.46]; haemorrhagic stroke 3.70 (OR); [1.05, 12.98] and age 0.01 (OR) [0.00, 69.89]. Only motor impairment was found as a significant predictor at six months post stroke 30.68 (OR); [1.60, 587.06]. LIMITATIONS: Low number of studies exploring biomechanical and neurophysiological in addition to behavioural predictors of spasticity were included. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: Using the results, the identified predictive markers have potential to better inform clinical decision-making and to plan specific rehabilitation interventions by physiotherapists for stroke survivors with upper limb spasticity. Systematic Review Registration Number PROSPERO (ID: CRD42016027642).
OBJECTIVE: To determine the predictive markers for the occurrence of upper limb spasticity in the first 12 months after stroke. DATA SOURCES: A systematic review was undertaken of the databases MEDLINE, EMBASE, CINAHL and PEDRO to 31st December 2017. STUDY SELECTION: Non-experimental or experimental studies that included a control group with spasticity who did not receive an experimental intervention which investigated at least one variable (explanatory variable) measured at baseline against the development (or not) of spasticity at a future time point within 12 months post stroke were selected independently by two reviewers. Eleven papers met the selection criteria. STUDY APPRAISAL: Data were extracted into tabular format using predefined data fields by two reviewers. Study quality was evaluated using the modified Downs and Black tool. Data were analysed using a meta-analysis or narrative review. RESULTS: Ten studies, including 856 participants were analysed. The predictive markers of upper limb spasticity at one month post stroke were: motor 11.25 (odds ratio, OR); [95% CI:2.48, 51.04] and sensory impairments 4.91 (OR); [1.24, 19.46]; haemorrhagic stroke 3.70 (OR); [1.05, 12.98] and age 0.01 (OR) [0.00, 69.89]. Only motor impairment was found as a significant predictor at six months post stroke 30.68 (OR); [1.60, 587.06]. LIMITATIONS: Low number of studies exploring biomechanical and neurophysiological in addition to behavioural predictors of spasticity were included. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: Using the results, the identified predictive markers have potential to better inform clinical decision-making and to plan specific rehabilitation interventions by physiotherapists for stroke survivors with upper limb spasticity. Systematic Review Registration Number PROSPERO (ID: CRD42016027642).
Authors: Alyson R Plecash; Amokrane Chebini; Alvin Ip; Joshua J Lai; Andrew A Mattar; Jason Randhawa; Thalia S Field Journal: Curr Neurol Neurosci Rep Date: 2019-11-13 Impact factor: 5.081