Abstract：
UNASSIGNED: To synthesize evidence on the effect of early post-stroke spasticity interventions.
UNASSIGNED: Systematic literature search (PubMed, Embase, and Web of Science) encompassing studies on spasticity reducing interventions within 3 months post stroke on outcome defined within the International Classification of Functioning (ICF).
UNASSIGNED: In total, 27 studies were identified with n = 1.658 cases. Botulinum toxin (2-12 weeks; 10 studies, n = 794) showed consistent and significant reduced spasticity by Modified Ashworth Scale (MAS) or electromyography (EMG). Electrical muscle stimulation (1-8 weeks; 6 studies, n = 335) showed lower MAS/Composite Spasticity Scale scores in 4 studies. Transcranial stimulation (3 studies; n = 131), oral spasmolytics (1 study; n = 38), shockwave (1 study; n = 40), orthotics (3 studies; n = 197 and robot-assisted therapy (3 studies; n = 123) showed inconclusive results. Effects on ICF activity domain could not be established due to limited data and large outcome measures heterogeneity. One out of two studies showed significant benefit for early compared to late BoNT intervention (< 90 vs> 90 days).
UNASSIGNED: This study provides evidence for early applied (<3 months) BoNT to effectively reduce spasticity and probable effectiveness of electrical stimulation. Establishing effects of interventions in the acute/hospitalization phase (<7 days) needs further work, specifically on the ICF activity domain. Standardization of outcome measures is required.
Spasticity, which may develop in the first weeks after stroke, is now mostly treated in the chronic phase.This study shows that early applied Botulinum Toxin (within three months after stroke) effectively reduces spasticity and suggests that electrical stimulation may reduce spasticity.Early application of treatment with Botulinum Toxin should be considered when spasticity occurs within three months post-stroke.
UNASSIGNED: Systematic literature search (PubMed, Embase, and Web of Science) encompassing studies on spasticity reducing interventions within 3 months post stroke on outcome defined within the International Classification of Functioning (ICF).
UNASSIGNED: In total, 27 studies were identified with n = 1.658 cases. Botulinum toxin (2-12 weeks; 10 studies, n = 794) showed consistent and significant reduced spasticity by Modified Ashworth Scale (MAS) or electromyography (EMG). Electrical muscle stimulation (1-8 weeks; 6 studies, n = 335) showed lower MAS/Composite Spasticity Scale scores in 4 studies. Transcranial stimulation (3 studies; n = 131), oral spasmolytics (1 study; n = 38), shockwave (1 study; n = 40), orthotics (3 studies; n = 197 and robot-assisted therapy (3 studies; n = 123) showed inconclusive results. Effects on ICF activity domain could not be established due to limited data and large outcome measures heterogeneity. One out of two studies showed significant benefit for early compared to late BoNT intervention (< 90 vs> 90 days).
UNASSIGNED: This study provides evidence for early applied (<3 months) BoNT to effectively reduce spasticity and probable effectiveness of electrical stimulation. Establishing effects of interventions in the acute/hospitalization phase (<7 days) needs further work, specifically on the ICF activity domain. Standardization of outcome measures is required.
Spasticity, which may develop in the first weeks after stroke, is now mostly treated in the chronic phase.This study shows that early applied Botulinum Toxin (within three months after stroke) effectively reduces spasticity and suggests that electrical stimulation may reduce spasticity.Early application of treatment with Botulinum Toxin should be considered when spasticity occurs within three months post-stroke.
摘要：
■综合早期卒中后痉挛干预措施效果的证据。
■系统文献检索(PubMed，Embase,和WebofScience），涵盖了在国际功能分类（ICF）中定义的卒中后3个月内减少痉挛的干预措施的研究。
■总共，27项研究确定n=1.658例。肉毒杆菌毒素（2-12周；10项研究，n=794）通过改良的Ashworth量表（MAS）或肌电图（EMG）显示出一致且显着的痉挛减轻。电肌肉刺激（1-8周；6项研究，n=335）在4项研究中显示较低的MAS/复合痉挛量表评分。经颅刺激（3项研究；n=131），口腔痉挛（1项研究；n=38），冲击波（1项研究；n=40），矫形器(3项研究;n=197;机器人辅助治疗(3项研究;n=123)显示结果不确定.由于有限的数据和较大的结果指标异质性，无法确定对ICF活性域的影响。两项研究中的一项显示了早期与晚期BoNT干预相比的显着益处（<90vs>90天）。
■这项研究为早期应用（<3个月）BoNT有效减少痉挛和电刺激的可能有效性提供了证据。在急性/住院阶段（<7天）建立干预措施的效果需要进一步的工作，特别是在ICF活性域上。需要对结果措施进行标准化。
痉挛，这可能在中风后的最初几周发展，现在主要在慢性期治疗。这项研究表明，早期应用肉毒杆菌毒素（中风后三个月内）可以有效地减少痉挛，并表明电刺激可以减少痉挛。当中风后三个月内出现痉挛时，应考虑早期应用肉毒杆菌毒素治疗。
■系统文献检索(PubMed，Embase,和WebofScience），涵盖了在国际功能分类（ICF）中定义的卒中后3个月内减少痉挛的干预措施的研究。
■总共，27项研究确定n=1.658例。肉毒杆菌毒素（2-12周；10项研究，n=794）通过改良的Ashworth量表（MAS）或肌电图（EMG）显示出一致且显着的痉挛减轻。电肌肉刺激（1-8周；6项研究，n=335）在4项研究中显示较低的MAS/复合痉挛量表评分。经颅刺激（3项研究；n=131），口腔痉挛（1项研究；n=38），冲击波（1项研究；n=40），矫形器(3项研究;n=197;机器人辅助治疗(3项研究;n=123)显示结果不确定.由于有限的数据和较大的结果指标异质性，无法确定对ICF活性域的影响。两项研究中的一项显示了早期与晚期BoNT干预相比的显着益处（<90vs>90天）。
■这项研究为早期应用（<3个月）BoNT有效减少痉挛和电刺激的可能有效性提供了证据。在急性/住院阶段（<7天）建立干预措施的效果需要进一步的工作，特别是在ICF活性域上。需要对结果措施进行标准化。
痉挛，这可能在中风后的最初几周发展，现在主要在慢性期治疗。这项研究表明，早期应用肉毒杆菌毒素（中风后三个月内）可以有效地减少痉挛，并表明电刺激可以减少痉挛。当中风后三个月内出现痉挛时，应考虑早期应用肉毒杆菌毒素治疗。
