Approaches of therapeutic exercise over lower limb spasticity after stroke: a systematic review
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Keywords

Exercise therapy
stroke
muscle spasticity
physical therapy modalities
rehabilitation

How to Cite

Bacca, O., Patiño, M. S., Herrera, E., & Barela, J. (2017). Approaches of therapeutic exercise over lower limb spasticity after stroke: a systematic review. Salud UIS, 49(2), 364–378. https://doi.org/10.18273/revsal.v49n2-2017009

Abstract

Introduction: Spasticity due to a stroke is one of the major changes that leads to sensorimotor deficits, causing postural control and functional capability deficits. In order to achieve the best possible functional recovery, several neuromuscular therapeutic exercise approaches have been employed (eg Rood, Bobath, Brunnstrom and proprioceptive neuromuscular facilitation), but still there are many doubts about the effectiveness of these interventions. Purpose: To perform a critical analysis of the available scientific evidence on the effect of the traditional approaches in spasticity recovery of the lower limbs in post-stroke individuals. Methods: Randomized controlled Trials available in PubMed, MEDLINE, PEDro, CINAHL, and Scopus data SCIENCEDIRECT bases were included in this study. The methodological quality of included articles was evaluated by the PEDro scale. Results: Eleven studies were included, obtaining a methodological quality of intermediate to high. The main observed limitations of the analyzed studies were: the absence of sample size estimation, the lack of blind evaluators, loss of participants, heterogeneous samples, lack of standardized protocols and diversity of employed variables. Conclusions: Based upon the results, it can be suggested that spasticity reduction can be effective applying from three to five days interventions per week, lasting 40 minutes. However, such suggestions are supported by studies with methodological limitations and employing different procedures that prevent a direct comparison among the studies. Therefore new studies are required to evaluate the effectiveness of such approaches, to implement physiotherapy interventions based on the scientific evidences that would further contribute to a better quality of life of post-stroke individuals. 
https://doi.org/10.18273/revsal.v49n2-2017009
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