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Stretching and Splinting Interventions for Poststroke Spasticity, Hand Function, and Functional Tasks: A Systematic

Lindsey Kerr1, Vanessa D Jewell2, Lou Jensen3

  • 1Lindsey Kerr, OTD, OTR/L, was Occupational Therapy Doctoral Student, Creighton University, Omaha, NE.

The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association
|August 18, 2020
PubMed
Summary

Stretching interventions show varied effectiveness for post-stroke upper extremity spasticity. Stretching devices offer strong evidence for reducing spasticity, while splinting and manual stretching show moderate evidence for improving hand function and functional tasks.

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Area of Science:

  • Neurorehabilitation
  • Physical Therapy
  • Occupational Therapy

Background:

  • Post-stroke spasticity is a common and debilitating motor impairment.
  • Upper extremity spasticity significantly impacts hand function and daily activities.

Purpose of the Study:

  • To synthesize evidence on stretching interventions for post-stroke upper extremity spasticity.
  • To evaluate the impact of stretching on hand function and functional task performance.

Main Methods:

  • Systematic review of Level I-III studies published between 2004 and 2017.
  • Searched multiple databases including MEDLINE, CINAHL, and Cochrane Library.
  • Included studies focused on adults with upper extremity spasticity receiving stretching interventions.

Main Results:

  • Strong evidence supports stretching devices for reducing spasticity.
  • Moderate evidence supports static splinting, dynamic splinting, and manual stretching for improving hand function and functional tasks.
  • Low evidence supports dynamic splinting and stretching devices for spasticity reduction; no evidence for manual stretching.

Conclusions:

  • Stretching interventions, particularly stretching devices, are effective for managing post-stroke upper extremity spasticity.
  • Splinting and manual stretching show promise for enhancing hand function and functional task performance.
  • Evidence synthesis guides clinical practice for optimizing rehabilitation outcomes in stroke survivors.