Purpose: To provide an overview of evidence for spinal cord injury (SCI) spasticity interventions in peerreviewed, published literature. Method: Structured review and synthesis of spasticity treatments in the literature. Each publication was rated according to the Downs and Black methodology for assessing nonrandomized studies and according to the Physiotherapy Evidence Database (PEDro) scale for assessing randomized controlled trials. Results: Level 1 evidence supports the use of transcutaneous electrical nerve stimulation (TENS), penile vibration, baclofen, tizanidine, clonidine, cyproheptadine, gabapentin, and Lthreonine to reduce spasticity in SCI. Conclusion: Although spasticity is a common complication following SCI, there is relatively little evidence for the treatment of spasticity and even less evidence that has been confirmed by independent replication. TENS is the only routine nonpharmacological treatment for spasticity that is supported by adequate level 1 evidence. Several pharmacological treatments, including baclofen, tizanidine, and clonidine, are supported by level 1 evidence. There is level 1 evidence to support test doses of intrathecal baclofen for the short-term reduction of spasticity in SCI but not for its long-term use. The lack of level 1 evidence for spasticity interventions does not necessarily reflect a lack of effective treatments, but it does emphasize the need for further studies. All other interventions reviewed would benefit from further study.
Spasticity After Spinal Cord Injury: An Evidence-Based Review of Current Interventions
Hsieh, Wolfe, Connolly, Townson, Curt, Blackmer, Sequeira, Aubut; Spasticity After Spinal Cord Injury: An Evidence-Based Review of Current Interventions. Top Spinal Cord Inj Rehabil 1 July 2007; 13 (1): 81–97. doi: https://doi.org/10.1310/sci1301-81
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