Physical treatment interventions for managing spasticity after stroke

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: Primary: To determine if physical treatment interventions are effective in preventing or minimising activity limitation and participation restrictions in those patients developing spasticity post stroke. Secondary: To determine if physical treatment interventions are effective in preventing or minimising impairment, burden of care, patient quality of life and economic burden in those patients developing spasticity post stroke. To identify any adverse effects of physical treatment interventions for spasticity post stroke. To determine whether, in stroke patients with established spasticity: standing is more effective than control, placebo or no intervention at managing spasticity; active exercise is more effective than control, placebo or no intervention at managing spasticity; passive exercising/stretching is more effective than control, placebo or no intervention at managing spasticity; positioning is more effective than control, placebo or no intervention at managing spasticity; and adjuncts to a physical programme are more effective than control, placebo or no intervention at managing spasticity. To explore the relationship between stroke characteristics, the extent of the established spasticity, acute (one to 12 months post stroke) versus chronic (greater than 12 months post stroke) spasticity, and the effect of physical interventions aimed at managing established spasticity post stroke, using subgroup analysis. standing is more effective than control, placebo or no intervention at managing spasticity; active exercise is more effective than control, placebo or no intervention at managing spasticity; passive exercising/stretching is more effective than control, placebo or no intervention at managing spasticity; positioning is more effective than control, placebo or no intervention at managing spasticity; and adjuncts to a physical programme are more effective than control, placebo or no intervention at managing spasticity.