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@article{190460,
        author = {Dr. Amar S. Damle and Dr. Monali Jadhav and Dr. Shubhangi Mukund and Dr.Gayatri Kalantri},
        title = {Physiotherapy Interventions for Post-Stroke Spasticity: A Systematic Review of Randomized Controlled Trials},
        journal = {International Journal of Innovative Research in Technology},
        year = {2026},
        volume = {12},
        number = {8},
        pages = {5290-5294},
        issn = {2349-6002},
        url = {https://ijirt.org/article?manuscript=190460},
        abstract = {Background: Post-stroke spasticity (PSS) is one of the most common and disabling sequelae of cerebrovascular accidents, affecting 30–40% of survivors within the first year. It manifests as hyperexcitability of the stretch reflex, increased muscle tone, and impaired voluntary movement, leading to contractures and reduced quality of life. Although pharmacological treatments such as botulinum toxin and baclofen can reduce spasticity, they are invasive, costly, and often produce transient effects. Physiotherapy offers a non-invasive and potentially sustainable alternative, yet evidence remains fragmented.
Objective:To systematically review and meta-analyze randomized controlled trials (RCTs) evaluating physiotherapy interventions for reducing post-stroke spasticity and improving motor and functional outcomes.
Methods:Databases including PubMed, Scopus, Web of Science, PEDro, and the Cochrane Library were searched from 2000 to 2025 in accordance with PRISMA 2020 guidelines. Eligible RCTs enrolled adults with post-stroke spasticity who received physiotherapy-based interventions such as neuromuscular electrical stimulation (NMES), dry needling, stretching, or robot-assisted therapy. The primary outcome was change in spasticity measured by the Modified Ashworth Scale (MAS). Secondary outcomes included Fugl-Meyer Assessment (motor recovery), 10-Meter Walk Test (mobility), and Barthel Index (ADL independence). Random-effects meta-analysis was conducted using Hedges’ g with 95% confidence intervals (CI).
Results:Eighteen RCTs (n = 1,245 participants) met inclusion criteria. Pooled analysis demonstrated a significant reduction in spasticity (Hedges’ g = -0.42, 95% CI: -0.56 to -0.28, p < 0.001; I² = 38%). Subgroup analysis showed NMES (g = -0.55) and dry needling (g = -0.48) produced the strongest effects, followed by robot-assisted therapy (g = -0.35) and stretching (g = -0.22). Improvements were also observed in motor recovery and ADL performance.
Conclusion: Physiotherapy interventions, particularly NMES and dry needling, significantly reduce post-stroke spasticity and improve functional outcomes. Robot-assisted and stretching therapies provide additional benefits. Early, multimodal physiotherapy should be a cornerstone of stroke rehabilitation.},
        keywords = {},
        month = {January},
        }