Best Practice Guidelines for the Management of Patients with Post-Stroke Spasticity: A Modified Scoping Review

Area of Science:

• Neurology
• Rehabilitation Medicine
• Evidence-Based Practice

Background:

• Post-stroke spasticity is a common and debilitating condition affecting motor function and quality of life.
• Effective management strategies are crucial for patient recovery and rehabilitation.
• A comprehensive overview of high-quality evidence is needed to guide clinical practice.

Purpose of the Study:

• To provide a concise overview of the best available evidence for managing post-stroke spasticity.
• To identify medical, rehabilitation, and surgical interventions with high-quality (GRADE A) evidence.
• To synthesize findings from systematic reviews and meta-analyses on post-stroke spasticity treatments.

Main Methods:

• A modified scoping review following PRISMA guidelines and PRISMA-ScR.
• Intensive literature search on Medline and PubMed (2000-2023).
• Inclusion of interventions with GRADE A evidence, assessed by two independent reviewers.

Main Results:

• Eleven treatments demonstrated GRADE A evidence for post-stroke spasticity management.
• These treatments include stretching, electrical stimulation, botulinum toxin A, and intrathecal baclofen.
• Evidence derived from 14 studies, primarily systematic reviews and meta-analyses.

Conclusions:

• Multimodal treatments with GRADE A evidence are effective for improving functional recovery in post-stroke spasticity.
• Key interventions include stretching, non-invasive stimulation, botulinum toxin A, and intrathecal baclofen.
• Further research into novel therapeutic options for post-stroke spasticity is encouraged.