Article

The purpose of this systematic
review was to determine the effectiveness of stretch for the treatment and
prevention of contractures.
The review is part of a more-detailed Cochrane
review. Only the results of the studies including patients with neurological
conditions are reported here. DATA SOURCES: Electronic searches were conducted in
June 2010 in the following computerized databases: Cochrane CENTRAL Register of
Controlled Trials, Database of Abstracts of Reviews of Effects (DARE), Health
Technology Assessment Database (HTA), MEDLINE, Cumulative Index to Nursing and
Allied Health Literature (CINAHL), EMBASE, SCI-EXPANDED, and Physiotherapy
Evidence Database (PEDro). STUDY ELIGIBILITY CRITERIA: The review included
randomized controlled trials and controlled clinical trials of stretch applied
for the purposes of treating or preventing contractures in people with
neurological conditions. STUDY APPRAISAL AND SYNTHESIS METHODS: Two reviewers
independently selected studies, extracted data, and assessed risk of bias. The
primary outcome measures were joint mobility (range of motion) and quality of
life. Secondary outcome measures were pain, spasticity, activity limitation, and
participation restriction. Meta-analyses were conducted using random-effects
models. RESULTS: Twenty-five studies met the inclusion criteria. These studies
provide moderate-quality evidence that stretch has a small immediate effect on
joint mobility (mean difference=3 degrees , 95% confidence interval [CI]=0
degrees to 5 degrees ) and high-quality evidence that stretch has little or no
short-term or long-term effects on joint mobility (mean difference=1 degrees and
0 degrees , respectively, 95% CI=0 degrees to 3 degrees and -2 degrees to 2
degrees , respectively). There is little or no effect of stretch on pain,
spasticity, and activity limitation. LIMITATIONS: No studies were retrieved that
investigated the effects of stretch for longer than 6 months. CONCLUSION: Regular
stretch does not produce clinically important changes in joint mobility, pain,
spasticity, or activity limitation in people with neurological conditions.

Langue : ANGLAIS