Stretching After Stroke for Spasticity

Rapid Review By: Mikayla Murphy

Kerr, L., Jewell, V. D., & Jensen, L. (2020). Stretching and splinting interventions for post stroke spasticity, hand function, and functional tasks: A systematic review. American Journal of Occupational Therapy, 74, 7405205050. https://doi.org/10.5014/ajot.2020.029454

The Skinny

This study focused on the benefits of stretching the upper extremity to decrease spasticity, increase hand function, and improve functional tasks in post stroke patients. The authors looked at four methods of reducing spasticity: stretching devices, static splinting, dynamic splinting, and manual stretching. 

In the Weeds 

This study was a systematic review, meaning it complied the results of several other studies in order to better understand all the current research evidence. The authors collected studies that focused on the treatment of the upper body of individuals 18 and older who had spasticity after a stroke. The studies also needed to have an evidence level of III or higher. The authors identified 11 studies that fit their criteria.

Bringing It Home

Stretching devices, static splinting, dynamic splinting, and manual stretching all increased hand function and improved functional tasks to varying degrees. Stretching devices were found to have strong evidence for reducing spasticity. Static and dynamic splinting both had low evidence for reducing spasticity, and manual stretching was not studied in regards to reducing spasticity. Static splinting, dynamic splinting, and manual stretching were found have moderate strength of evidence for increasing hand function. Stretching devices had a low strength of evidence for increasing hand function. Static splinting, dynamic splinting, and manual evidence all had a moderate strength of evidence for improving functional tasks. Stretching devices again had a low strength of evidence for improving functional tasks.

There were also some non-statistically significant conclusions drawn. Dynamic splinting was more effective than static splinting by self-report. Interventions were more effective when done in conjunction with an occupational or physical therapy session (as opposed to simply with a home exercise program), highlighting the need for hands-on intervention in addition to stretching activities. 

Rating

This study was a 3/5. The systematic review itself was well-done, but severely limited by the lack of available studies. Additionally, the studies were not homogenous. For example, the intervention periods ranged from a half hour to six months between studies. In the end, the review does not change practice, but primarily highlights a need for more research in regards to upper extremity stretching and post-stroke spasticity.

2 Comments

  1. Gabrielle Watkins on November 6, 2023 at 4:52 pm

    Can you provide an example of a stretching device? Thank you.

  2. Allison on November 8, 2023 at 6:01 am

    What would constitute a stretching device?

Leave a Comment






More To Read

Is therapy needed after a distal radius fracture?

July 24, 2021

Coughlin T, Norrish AR, Scammell BE, Matthews PA, Nightingale J, Ollivere BJ. Comparison of rehabilitation interventions in nonoperatively treated distal radius fractures: a randomized controlled trial of effectiveness. Bone Joint J. 2021Jun;103-B(6):1033-1039. doi: 10.1302/0301-620X.103B.BJJ-2020-2026.R1.Epub 2021 Apr 30. PMID: 33926211. The Skinny: Individuals with distal radius fractures are very common in the hand therapy world. This…

Read More

Hand Therapy:Integra Dermal regeneration For Patients with Burns, Scars, or Wound Reconstruction

July 26, 2020

By: Taylor Volentine Date: 6/6/2020 Is it possible for shark and cow cartilage to improve the healing process for patients with burns, scars, or reconstruction of wounds? It sure is! A solution to the problem is Integra Dermal Regeneration Template.  What is Integra Dermal Regeneration? The skin is made of two layers consisting of the…

Read More

How to Get Started in Hand Therapy

March 5, 2019

I started OT school knowing that I wanted to do pediatrics. I set up everything to build up my resume for my first therapy job to be in pediatrics. Along the way I had a 3 month clinical rotation in hand therapy at Mayo Clinic in Scottsdale. That experience peaked my interest in hands. 13…

Read More
Envelope_1

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.