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Stretch for the treatment and prevention of contracture: an abridged republication of a Cochrane systematic review [with consumer summary]
Harvey LA, Katalinic OM, Herbert RD, Moseley AM, Lannin NA, Schurr K
Journal of Physiotherapy 2017 Apr;63(2):67-75
systematic review

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.

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