Cochrane · systematic review · CD008929
Interventions for managing skeletal muscle spasticity following traumatic brain injury
Synnot, A, Chau, M, Pitt, V, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
InjuriesAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
9
No studies
12
Included studies
NR
No studies 12 · 57.1%Ungraded 0 · 0%Very low 6 · 28.6%Low 3 · 14.3%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Baclofen compared with placebo for spasticity in people with traumatic brain injury
Population: adults with traumatic brain injury with spasticity in their arms and legs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spasticity at up to 6 hours after treatment (measured by the Ashworth Scale, 0‐, with a higher score indicating greater spasticity) Baclofen vs placebo | no estimate extracted | 1 study · 11 participants | Low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Adverse events Baclofen vs placebo | no estimate extracted | 1 study · 11 participants | Low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Sensory functions and pain Baclofen vs placebo | no estimate extracted | NR | No studies |
Neuromusculoskeletal and movement‐related functions up to 6 hours after treatment (Measured by spasm and deep tendon reflex scores, 0‐5, with 0 being no reflexes and 5 being clonus, or repeated involuntary muscle contractions) Baclofen vs placebo | no estimate extracted | 1 study · 11 participants | Low Downgraded: risk of bias, imprecision, indirectness, publication bias |
General tasks and demands Baclofen vs placebo | no estimate extracted | NR | No studies |
Mobility Baclofen vs placebo | no estimate extracted | NR | No studies |
Self‐care Baclofen vs placebo | no estimate extracted | NR | No studies |
Botulinum toxin A (with and without casting) compared with placebo (with and without casting) for spasticity in people with traumatic brain injury
Population: adults with traumatic brain injury with spasticity in their arms (1 study) or calves (1 study)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spasticity at 4‐12 weeks (measured by both Modified Ashworth Scale, 0‐5, at 12 weeks and Tardieu Scale, 0‐5, at 4 weeks) Botulinum toxin A (with and without casting) vs placebo (with and without casting) | no estimate extracted | 2 studies · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Adverse events Botulinum toxin A (with and without casting) vs placebo (with and without casting) | no estimate extracted | 2 studies · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Sensory functions and pain Botulinum toxin A (with and without casting) vs placebo (with and without casting) | no estimate extracted | NR | No studies |
Neuromusculoskeletal and movement‐related functions at 12 weeks (measured by ankle dorsiflexion) Botulinum toxin A (with and without casting) vs placebo (with and without casting) | no estimate extracted | 2 studies · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
General tasks and demands Botulinum toxin A (with and without casting) vs placebo (with and without casting) | no estimate extracted | NR | No studies |
Mobility Botulinum toxin A (with and without casting) vs placebo (with and without casting) | no estimate extracted | NR | No studies |
Self‐care Botulinum toxin A (with and without casting) vs placebo (with and without casting) | no estimate extracted | NR | No studies |
Pseudoelastic orthosis versus traditional (static) splint for spasticity in people with traumatic brain injury
Population: children/young people aged 4‐18 years with traumatic brain injury and with 'mild to severe spastic tetraparesis' (weakness) in all limbs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spasticity at up to 6 hours after treatment (measured by the Modified Ashworth Scale, 0‐4, with a higher score indicating greater spasticity) Pseudoelastic orthosis vs traditional (static) splint | no estimate extracted | 1 study · 25 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Adverse events Pseudoelastic orthosis vs traditional (static) splint | no estimate extracted | 1 study · 25 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Sensory functions and pain Pseudoelastic orthosis vs traditional (static) splint | no estimate extracted | NR | No studies |
Neuromusculoskeletal and movement‐related functions post treatment (measured by range of movement) Pseudoelastic orthosis vs traditional (static) splint | no estimate extracted | 1 study · 25 participants | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
General tasks and demands Pseudoelastic orthosis vs traditional (static) splint | no estimate extracted | NR | No studies |
Mobility Pseudoelastic orthosis vs traditional (static) splint | no estimate extracted | NR | No studies |
Self‐care Pseudoelastic orthosis vs traditional (static) splint | no estimate extracted | NR | No studies |