Stretching after spinal cord injury: a call for evidence for this common clinical practice

Front. Rehabil. Sci., 2024 · DOI: 10.3389/fresc.2024.1505439 · Published: December 10, 2024

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

Stretching is a common rehabilitation technique used for individuals with spinal cord injury (SCI) to reduce spasticity, maintain joint range of motion, and prevent contractures. However, there is limited evidence to support the effectiveness of stretching for people with SCI, especially regarding long-term effects and its impact on motor function. Studies in rats with SCI have shown that stretching can impair motor output, reduce spinal cord excitability, and abolish walking function, raising concerns about its potential negative effects.

Study Duration

Not specified

Participants

Humans and rats with SCI

Evidence Level

Perspective paper

Key Findings

1
Stretching does not have clinically meaningful effects on joint mobility or reduce the risk of contractures in people with SCI.
2
Limited evidence supports the use of stretching for spasticity in people with SCI, although some studies show short-term reductions in quadriceps muscle spasticity.
3
In rat models of SCI, stretching abolished locomotion and hindlimb function, suggesting that it may negatively impact voluntary motor output.

Research Summary

This perspective paper discusses the evidence regarding the effects of stretching as a rehabilitation strategy for people with spinal cord injury (SCI). The paper challenges assumptions about the benefits of stretching and encourages research to better understand its effects on range of motion, contractures, and motor output. The authors call for further investigation into the mechanisms underlying stretch-induced effects and the development of guidelines for the appropriate use of stretching in SCI rehabilitation.

Practical Implications

Re-evaluate Stretching Practices

Clinicians should critically evaluate the routine prescription of stretching for individuals with SCI, considering the limited evidence of its effectiveness and potential for adverse outcomes.

Prioritize Research

More research is needed to investigate the mechanisms underlying the effects of stretching, including its impact on motor output, spasticity, and joint mobility.

Develop Optimized Protocols

Future research should focus on developing optimized stretching protocols that maximize potential benefits while minimizing the risk of negative effects on motor function.

Study Limitations

1
Lack of studies evaluating the effect of stretching on voluntary motor output in humans with SCI.
2
Limited empirical evidence supporting the use of stretching for spasticity in people with SCI.
3
Experimental findings in rodent models may not directly translate to humans with SCI.

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