TY - JOUR
T1 - Effectiveness of Physiotherapy Interventions on Spasticity in People with Multiple Sclerosis
T2 - A Systematic Review and Meta-Analysis
AU - Etoom, Mohammad
AU - Khraiwesh, Yazan
AU - Lena, Francesco
AU - Hawamdeh, Mohannad
AU - Hawamdeh, Ziad
AU - Centonze, Diego
AU - Foti, Calogero
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Objective The aim of the study was to examine the effectiveness of physiotherapy (PT) interventions on spasticity in people with multiple sclerosis. Design A systematic search was performed using PRISMA guidance. Studies evaluate the effect of PT interventions on spasticity were included. People with multiple sclerosis, spasticity, disability and PT interventions characteristics were extracted in included studies. Level of evidence was synthesized by the Grade of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed by calculating Hedges g at 95% confidence interval. Results A total of 29 studies were included in the review, and 25 were included in the meta-analyses. The included PT interventions were exercise therapy, electrical stimulation, radial shock wave therapy, vibration, and standing. The review and meta-analyses showed different evidences of benefits and nonbenefits for PT interventions on some spasticity outcomes. The best quality evidences were for beneficial effects of exercise therapy especially robot gait training and outpatient exercise programs on self-perceived spasticity and muscle tone respectively. The review results were positive regarding the acute effects, follow-up measurements, safety, progressive MS, and nonambulatory people with multiple sclerosis. The included articles were heterogeneous and badly reported in PT interventions and people with multiple sclerosis characteristics. Conclusions Physiotherapy interventions can be a safe and beneficial option for spasticity in people with multiple sclerosis. No firm conclusion can be drawn on overall spasticity. Further researches in different spasticity aspects are needed.
AB - Objective The aim of the study was to examine the effectiveness of physiotherapy (PT) interventions on spasticity in people with multiple sclerosis. Design A systematic search was performed using PRISMA guidance. Studies evaluate the effect of PT interventions on spasticity were included. People with multiple sclerosis, spasticity, disability and PT interventions characteristics were extracted in included studies. Level of evidence was synthesized by the Grade of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed by calculating Hedges g at 95% confidence interval. Results A total of 29 studies were included in the review, and 25 were included in the meta-analyses. The included PT interventions were exercise therapy, electrical stimulation, radial shock wave therapy, vibration, and standing. The review and meta-analyses showed different evidences of benefits and nonbenefits for PT interventions on some spasticity outcomes. The best quality evidences were for beneficial effects of exercise therapy especially robot gait training and outpatient exercise programs on self-perceived spasticity and muscle tone respectively. The review results were positive regarding the acute effects, follow-up measurements, safety, progressive MS, and nonambulatory people with multiple sclerosis. The included articles were heterogeneous and badly reported in PT interventions and people with multiple sclerosis characteristics. Conclusions Physiotherapy interventions can be a safe and beneficial option for spasticity in people with multiple sclerosis. No firm conclusion can be drawn on overall spasticity. Further researches in different spasticity aspects are needed.
KW - Multiple Sclerosis
KW - Muscle Spasticity
KW - Physical Therapy Modalities
KW - Rehabilitation
KW - Review [Publication Type]
UR - http://www.scopus.com/inward/record.url?scp=85055078341&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055078341&partnerID=8YFLogxK
U2 - 10.1097/PHM.0000000000000970
DO - 10.1097/PHM.0000000000000970
M3 - Review article
C2 - 29794531
AN - SCOPUS:85055078341
VL - 97
SP - 793
EP - 807
JO - American Journal of Physical Medicine and Rehabilitation
JF - American Journal of Physical Medicine and Rehabilitation
SN - 0894-9115
IS - 11
ER -