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Assistive technology, including orthotic devices, for the management of contractures in adult stroke patients

  1. Rasheed Ahamed Mohammed Meeran1,*,
  2. Venugopal Durairaj2,
  3. Padmanaban Sekaran3,
  4. Sybil E Farmer4,
  5. Anand D Pandyan3

Editorial Group: Cochrane Stroke Group

Published Online: 10 OCT 2013

Assessed as up-to-date: 8 AUG 2013

DOI: 10.1002/14651858.CD010779

How to Cite

Mohammed Meeran RA, Durairaj V, Sekaran P, Farmer SE, Pandyan AD. Assistive technology, including orthotic devices, for the management of contractures in adult stroke patients (Protocol). Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD010779. DOI: 10.1002/14651858.CD010779.

Author Information

  1. 1

    Holy Cross Hospital, Physiotherapy Department, Haslemere, Surrey, UK

  2. 2

    South Staffordshire and Stoke-on-Trent Partnership Trust, Provider Services, Burton-on-Trent, UK

  3. 3

    Keele University, School of Health and Rehabilitation, Keele, UK

  4. 4

    Keele University, Research Institute for Life Course Studies, Keele, UK

*Rasheed Ahamed Mohammed Meeran, Physiotherapy Department, Holy Cross Hospital, Hindhead Road, Haslemere, Surrey, GU27 1NQ, UK.

Publication History

  1. Publication Status: New
  2. Published Online: 10 OCT 2013



Additional references

Ada 2006
  • Ada L, O’Dwyer N, O’Neill E. Relation between spasticity, weakness and contracture of the elbow flexors and upper limb activity after stroke: an observational study. Disability and Rehabilitation 2006;28(13-14):891-7.
Bhakta 2000
  • Bhakta BB, Cozens JA, Bamford JM, Chamberlain MA. The impact of botulinum toxin on disability related to severe upper limb spasticity after stroke: a double blind randomised placebo controlled trial. Journal of Neurology, Neurosurgery and Psychiatry 2000;69:217-21.
Bohannon 1987
Botte 1988
  • Botte MJ, Nickel VL, Akeson WH. Spasticity and contractures. Physiological aspects of formation. Clinical Orthopedics 1988;233:7-11.
Domholdt 2005
Duncan 1987
  • Duncan PW, Badke MB. Determinants of abnormal motor control. In: Duncan PW, Badke MB editor(s). The Recovery of Motor Control. Chicago, IL: Year Book Medical Publishers, 1987:135-58.
Duong 2001
Farmer 2001
  • Farmer SE, James M. Contractures in orthopaedic and neurological conditions: a review of causes and treatment. Disability and Rehabilitation 2001;10(23):549-58.
Goldspink 1974
  • Goldspink G, Tabary C, Tabary JC, Tardieu C, Tardieu G. Effect of denervation on the adaptation of sarcomere number and muscle extensibility to the functional length of the muscle. Journal of Physiology 1974;236(3):733-42.
Harburn 1993
  • Harburn KL, Potter PJ. Spasticity and contractures. Physical Medicine and Rehabilitation 1993;7:113-32.
Harvey 2006
  • Harvey L, De Jong I, Goehl G, Mardwedel S. Twelve weeks of nightly stretch does not reduce thumb web-space contractures in people with a neurological condition: a randomised controlled trial. Australian Journal of Physiotherapy 2006;52(4):251-8.
Hatano 1976
  • Hatano S. Experience from a multicentre stroke register: a preliminary report. Bulletin of the World Health Organization 1976; Vol. 54:541-53.
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from
Katalinic 2010
Kwah 2012
  • Kwah LK, Herbert RD, Harvey LA, Diong J, Clarke JL, Martin JH, et al. Passive mechanical properties of gastrocnemius muscles of people with ankle contracture after stroke. Archives of Physical Medicine and Rehabilitation 2012;93(7):1185-90.
Lance 1980
  • Lance JW, Feldman RG, Young RR, Koella WP. Spasticity: Disordered Motor Control. Chicago: Year Book, 1980.
Lannin 2003
Lannin 2007
Lannin 2011
Liberati 2009
Lieber 2010
  • Lieber RL. Skeletal Muscle Structure Function & Plasticity - The Physiological Basis of Rehabilitation. 3rd Edition. Philadelphia: Lippincott Williams and Wilkins, 2010.
Magee 2006
  • Magee D. Orthopedic Physical Assessment. Fourth. Philadelphia: Elsevier Sciences, 2006.
Malhotra 2008
  • Malhotra S, Cousins E, Ward A, Day C, Jones P, Roffe C, et al. An investigation into the agreement between clinical, biomechanical and neurophysiological measures of spasticity. Clinical Rehabilitation 2008;22:1105-15.
Malhotra 2011
  • Malhotra S, Pandyan AD, Rosewilliam S, Roffe C, Hermens H. Spasticity and contractures at the wrist after stroke: time course of development and their association with functional recovery of the upper limb. Clinical Rehabilitation 2011;25(2):184-91.
Mehrholz 2005
  • Mehrholz J, Wagner K, Messiner D, Grundmann K, Zange C, Koch R, et al. Reliability of the modified Tardieu scale and the modified Ashworth scale in adult patients with severe brain injury: a comparison study. Clinical Rehabilitation 2005;19(7):751-9.
Milazzo 1998
  • Milazzo S, Gillen G. Splinting applications. In: Gillen G, Burkhardt A editor(s). Stroke Rehabilitation: A Function-Based Approach. St Louis: Mosby, 1998:161–84.
Monaghan 2011
  • Monaghan K, Horgan F, Blake C, Cornall C, Hickey PPM, Lyons BE, et al. Physical treatment interventions for managing spasticity after stroke. Cochrane Database of Systematic Reviews 2011, Issue 7. [DOI: 10.1002/14651858.CD009188]
Moseley 2008
  • Moseley AM, Hassett LM, Leung J, Clare JS. Serial casting versus positioning for the treatment of elbow contractures in adults with traumatic brain injury: a randomized controlled trial. Clinical Rehabilitation 2008;22:406-17.
NAO 2005
  • National Audit Office. Department of Health Reducing Brain Damage: Faster access to better stroke care. Report by the Comptroller and Auditor General 16 November 2005; Vol. HC 452 Session 2005-2006.
O'Dwyer 1996
Pandyan 1997
Pandyan 1999
  • Pandyan AD, Johnson GR, Price CIM, Curless RH, Barnes MP, Rodgers H. A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity. Clinical Rehabilitation 1999;12:373-83.
Pandyan 2001
Petty 2001
  • Petty NJ, Moore AP. Neuromusculoskeletal Examination and Assessment: A Handbook for Therapists. Second Edition. Churchill Livingstone, 2001.
RevMan 2012 [Computer program]
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.
Sackley 2008
  • Sackley C, Brittle N, Patel S, Ellins J, Scott M, Wright C, et al. The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls and depression in the year after a severely disabling stroke. Stroke 2008;39:3329-34.
Tyson 2009
  • Tyson SF, Kent RM. Orthotic devices after stroke and other non-progressive brain lesions. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD003694.pub3]
Wheatley-Smith 2012
  • Wheatley-Smith L, McGuinness S, Wilson FC, Scott G, McCann J, Caldwell S. Intensive physiotherapy for vegetative and minimally conscious state patients: a retrospective audit and analysis of therapy intervention. Disability and Rehabilitation 2013;35(12):1006-14.
Williams 1990
Yeh 2005
  • Yeh CY, Tsai KH, Chen JJJ. Effects of prolonged muscle stretching with constant torque or constant-angle on hypertonic calf muscles. Archives of Physical Medicine and Rehabilitation 2005;86:235-41.
Yip 1996
  • Yip B, Stewart DA, Roberts MA. The prevalence of joint contractures in residents in NHS continuing care. Health Bulletin 1996; Vol. 54, issue 4:338-43.