Passive movement interventions and spasticity outcomes in individuals with spinal cord injury during rehabilitation:...

Scoping review.

Spasticity is a common and often challenging sequela of spinal cord injury (SCI) associated with pain, contractures, and reduced quality of life. While passive movement (PM) is primarily used to maintain joint mobility, clinical observations and participant reports suggest that both manual and automated techniques can contribute to the management of spasticity in SCI. However, the evidence base concerning PM's impact on spasticity outcomes in SCI populations remains unclear. This review aims to identify the scope and synthesize the empirical evidence of PM interventions for managing spasticity in individuals with SCI.

Seven databases (Embase, Medline, PsycInfo, Web of Science, Scopus, CENTRAL, and CINAHL) were systematically searched. Eligible studies were peer-reviewed, reported original data, included adult participants (≥18 years) with SCI, presented a therapeutic intervention consisting solely of PM techniques, and reported any spasticity outcome. Data were extracted and analyzed by two independent reviewers.

The initial search identified 1628 unique studies, of which 13 were included for analysis. The PM interventions included passive cycling and robotic PM interventions (n = 8), continuous passive motion (n = 4), and manual passive range of motion (PROM) (n = 1). While a minority of studies demonstrated sustained improvements in spasticity outcomes, the majority reported short-term reductions observed in small sample groups, single-session experiments, or using suboptimal research designs.

This review assembled the existing evidence on PM interventions for managing spasticity in individuals with SCI. Despite finding consistent short-term improvements, further high-quality research is needed to determine clinical efficacy and inform future rehabilitation practices.