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J Physiother. 2017 Apr;63(2):67-75. doi: 10.1016/j.jphys.2017.02.014. Epub 2017 Mar 14.

Stretch for the treatment and prevention of contracture: an abridged republication of a Cochrane Systematic Review.

Author information

1
John Walsh Centre for Rehabilitation Research, Northern Clinical School, Sydney School of Medicine, University of Sydney.
2
Neuroscience Research Australia.
3
The George Institute for Global Health, Sydney Medical School, University of Sydney.
4
School of Allied Health, Department of Community and Clinical Allied Health, Occupational Therapy, College of Science, Health and Engineering, La Trobe University, Melbourne.
5
Physiotherapy Consultant, Sydney, Australia.

Abstract

QUESTION:

Is stretch effective for the treatment and prevention of contractures in people with neurological and non-neurological conditions?

DESIGN:

A Cochrane Systematic Review with meta-analyses of randomised trials.

PARTICIPANTS:

People with or at risk of contractures.

INTERVENTION:

Trials were considered for inclusion if they compared stretch to no stretch, or stretch plus co-intervention to co-intervention only. The stretch could be administered in any way.

OUTCOME MEASURES:

The outcome of interest was joint mobility. Two sets of meta-analyses were conducted with a random-effects model: one for people with neurological conditions and the other for people with non-neurological conditions. The quality of evidence supporting the results of the two sets of meta-analyses was assessed using GRADE.

RESULTS:

Eighteen studies involving 549 participants examined the effectiveness of stretch in people with neurological conditions, and provided useable data. The pooled mean difference was 2 deg (95% CI 0 to 3) favouring stretch. This was equivalent to a relative change of 2% (95% CI 0 to 3). Eighteen studies involving 865 participants examined the effectiveness of stretch in people with non-neurological conditions, and provided useable data. The pooled standardised mean difference was 0.2 SD (95% CI 0 to 0.3) favouring stretch. This translated to an absolute mean increase of 1 deg (95% CI 0 to 2) and a relative change of 1% (95% CI 0 to 2). The GRADE level of evidence was high for both sets of meta-analyses.

CONCLUSION:

Stretch does not have clinically important effects on joint mobility. [Harvey LA, Katalinic OM, Herbert RD, Moseley AM, Lannin NA, Schurr K (2017) Stretch for the treatment and prevention of contracture: an abridged republication of a Cochrane Systematic Review. Journal of Physiotherapy 63: 67-75].

KEYWORDS:

Contracture; Physical therapy; Stretch; Systematic review

PMID:
28433236
DOI:
10.1016/j.jphys.2017.02.014
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