Evidence of treating spasticity before it develops: a systematic review of spasticity outcomes in acute spinal cord injury interventional trials

Therapeutic Advances in Neurological Disorders, 2022 · DOI: 10.1177/17562864211070657 · Published: January 1, 2022

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

Spasticity, a common issue after spinal cord injury (SCI), can significantly impair function. This review examines if early treatments post-SCI can prevent or lessen spasticity. The review analyzes clinical trials that tested interventions soon after SCI and measured spasticity outcomes to determine the impact of early intervention. The study found limited research on early spasticity interventions in SCI patients, highlighting a need for more studies to explore preventive strategies.

Study Duration

Not specified

Participants

Systematic review of 8 human trials (195 patients) and 9 animal studies

Evidence Level

Systematic Review

Key Findings

1
Animal studies suggest early interventions can reduce spasticity after SCI, influencing electrophysiological, behavioral, and histological measures.
2
Only one human study measured spasticity as a primary outcome with sufficient sample size, showing that neuromodulation reduced lower extremity spasticity.
3
There is a significant lack of research focused on early interventions to mitigate spasticity in SCI, despite its prevalence and impact.

Research Summary

This systematic review investigates the potential of early interventions to mitigate spasticity development after spinal cord injury (SCI). The review identified and analyzed control trials in both humans and animals, focusing on interventions performed during the acute phase of SCI and their impact on spasticity outcomes. The findings indicate a need for more research on early interventions to prevent or treat spasticity in SCI, with animal studies suggesting promising avenues for clinical translation.

Practical Implications

Early Intervention Strategies

Emphasizes the importance of implementing early intervention strategies to mitigate spasticity development post-SCI, potentially improving long-term outcomes.

Research Focus

Highlights the necessity for more research on early interventions targeting spasticity to inform clinical practice and address the current gap in evidence.

Clinical Trial Design

Suggests that future clinical trials in SCI, regardless of primary objective, should include spasticity as an outcome measure to assess potential benefits of early interventions.

Study Limitations

1
Limited number of human trials studying early interventions for spasticity after SCI.
2
Heterogeneity in outcome measures used across studies, making comparisons challenging.
3
Potential for missed trials due to language restrictions and focus on active control groups.

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