Centre for Evidence Based Hand Surgery


Stroke & adult spasticity




Royal College of Occupational Therapists - Splinting for the prevention and correction of contractures in adults with neurological dysfunction: practice guideline for occupational therapists and physiotherapists (2015)

Spasticity in adults: management using botulinum toxin. National guidelines.
Royal College of Physicians, British Society of Rehabilitation Medicine, The Chartered Society of Physiotherapy, Association of Chartered Physiotherapists in Neurology and the Royal College of Occupational Therapists.
London: Royal College of Physicians, 2018.



Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke.
Barclay RE, Stevenson TJ, Poluha W, Semenko B, Schubert J.
Cochrane Database Syst Rev. 2020 May 25;5:CD005950. doi: 10.1002/14651858.CD005950.pub5.

Action observation for upper limb rehabilitation after stroke.
Borges LR, Fernandes AB, Melo LP, Guerra RO, Campos TF.
Cochrane Database Syst Rev. 2018 Oct 31;10:CD011887. doi: 10.1002/14651858.CD011887.pub2.

Stretch for the treatment and prevention of contractures.
Harvey LA, Katalinic OM, Herbert RD, Moseley AM, Lannin NA, Schurr K.
Cochrane Database Syst Rev. 2017 Jan 9;1:CD007455. doi: 10.1002/14651858.CD007455.pub3.

Interventions for improving upper limb function after stroke.
Pollock A, Farmer SE, Brady MC, Langhorne P, Mead GE, Mehrholz J, van Wijck F.
Cochrane Database Syst Rev. 2014 Nov 12;11:CD010820. doi: 10.1002/14651858.CD010820.pub2.

Hands-on therapy interventions for upper limb motor dysfunction following stroke.
Winter J, Hunter S, Sim J, Crome P.
Cochrane Database Syst Rev. 2011 Jun 15;(6):CD006609. doi: 10.1002/14651858.CD006609.pub2.

Dynamic hand orthoses for the recovery of hand and arm function in adults after stroke: A systematic review and meta-analysis of randomised controlled trials.
Alexander J, Dawson J, Langhorne P.
Top Stroke Rehabil. 2021 Jan 31:1-11. doi: 10.1080/10749357.2021.1878669. Online ahead of print.

Robot-assisted therapy for upper extremity motor impairment after stroke: a systematic review and meta-analysis.
Wu J, Cheng H, Zhang J, Yang S, Cai S.
Phys Ther. 2021 Jan 18:pzab010. doi: 10.1093/ptj/pzab010. Online ahead of print.

Brain-computer interface robotics for hand rehabilitation after stroke: a systematic review.
Baniqued PDE, Stanyer EC, Awais M, Alazmani A, Jackson AE, Mon-Williams MA, Mushtaq F, Holt RJ.
J Neuroeng Rehabil. 2021 Jan 23;18(1):15. doi: 10.1186/s12984-021-00820-8.

Stretching and splinting interventions for poststroke spasticity, hand function, and functional tasks: A systematic review.
Kerr L, Jewell VD, Jensen L.
Am J Occup Ther. 2020 Sep/Oct;74(5):7405205050p1-7405205050p15. doi: 10.5014/ajot.2020.029454.

The effect of priming on outcomes of task-oriented training for the upper extremity in chronic stroke: a systematic review and meta-analysis.
da Silva ESM, Ocamoto GN, Santos-Maia GLD, de Fátima Carreira Moreira Padovez R, Trevisan C, de Noronha MA, Pereira ND, Borstad A, Russo TL.
Neurorehabil Neural Repair. 2020 May 26:1545968320912760. doi: 10.1177/1545968320912760. [Epub ahead of print]

Synergistic effect of combined mirror therapy on upper extremity in patients with stroke: A systematic review and meta-analysis.
Luo Z, Zhou Y, He H, Lin S, Zhu R, Liu Z, Liu J, Liu X, Chen S, Zou J, Zeng Q.
Front Neurol. 2020 Apr 2;11:155. doi: 10.3389/fneur.2020.00155. eCollection 2020.

Immediate and long-term effects of BCI-based rehabilitation of the upper extremity after stroke: a systematic review and meta-analysis.
Bai Z, Fong KNK, Zhang JJ, Chan J, Ting KH.
J Neuroeng Rehabil. 2020 Apr 25;17(1):57. doi: 10.1186/s12984-020-00686-2.

The effect of rehabilitation interventions on physical function and immobility-related complications in severe stroke: a systematic review.
McGlinchey MP, James J, McKevitt C, Douiri A, Sackley C.
BMJ Open. 2020 Feb 5;10(2):e033642. doi: 10.1136/bmjopen-2019-033642.

Effectiveness of focal muscle vibration on hemiplegic upper extremity spasticity in individuals with stroke: A systematic review.
Alashram AR, Padua E, Romagnoli C, Annino G.
NeuroRehabilitation. 2019 Dec 18. doi: 10.3233/NRE-192863. [Epub ahead of print]

Effectiveness of virtual reality- and gaming-based interventions for upper extremity rehabilitation post-stroke: A meta-analysis.
Karamians R, Proffitt R, Kline D, Gauthier LV.
Arch Phys Med Rehabil. 2019 Dec 7. pii: S0003-9993(19)31438-8. doi: 10.1016/j.apmr.2019.10.195. [Epub ahead of print]

Virtual rehabilitation of upper extremity function and independence for st[r]oke: a meta-analysis.
Ahn S, Hwang S.
J Exerc Rehabil. 2019 Jun 30;15(3):358-369. doi: 10.12965/jer.1938174.087. eCollection 2019 Jun.

Acupuncture for post-stroke shoulder-hand syndrome: A systematic review and meta-analysis.
Liu S, Zhang CS, Cai Y, Guo X, Zhang AL, Xue CC, Lu C.
Front Neurol. 2019 Apr 26;10:433. doi: 10.3389/fneur.2019.00433. eCollection 2019.

Duration of treatment effect of extracorporeal shock wave on spasticity and subgroup-analysis according to number of shocks and application site: A meta-analysis.
Oh JH, Park HD, Han SH, Shim GY, Choi KY.
Ann Rehabil Med. 2019 Apr;43(2):163-177. doi: 10.5535/arm.2019.43.2.163. Epub 2019 Apr 30.

Systematic review of orthoses for stroke-induced upper extremity deficits.
Pritchard K, Edelstein J, Zubrenic E, Tsao L, Pustina K, Berendsen M, Wafford E.
Top Stroke Rehabil. 2019 Jul;26(5):389-398. doi: 10.1080/10749357.2019.1599172. Epub 2019 Apr 7.

Electromyogram-related neuromuscular electrical stimulation for restoring wrist and hand movement in poststroke hemiplegia: A systematic review and meta-analysis.
Monte-Silva K, Piscitelli D, Norouzi-Gheidari N, Batalla MAP, Archambault P, Levin MF.
Neurorehabil Neural Repair. 2019 Feb;33(2):96-111. doi: 10.1177/1545968319826053. Epub 2019 Feb 1.

Effectiveness of botulinum toxin treatment for upper limb spasticity after stroke over different ICF domains: a systematic review and meta-analysis.
Andringa A, van de Port I, van Wegen E, Ket J, Meskers C, Kwakkel G.
Arch Phys Med Rehabil. 2019 Feb 20. pii: S0003-9993(19)30107-8. doi: 10.1016/j.apmr.2019.01.016. [Epub ahead of print]

Does resting motor threshold predict motor hand recovery after stroke?
Rosso C, Lamy JC.
Front Neurol. 2018 Nov 29;9:1020. doi: 10.3389/fneur.2018.01020. eCollection 2018.

Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: Systematic review with meta-analysis.
Salazar AP, Pinto C, Ruschel Mossi JV, Figueiro B, Lukrafka JL, Pagnussat AS.
Ann Phys Rehabil Med. 2018 Dec 22. pii: S1877-0657(18)31497-0. doi: 10.1016/j.rehab.2018.11.004. [Epub ahead of print]

Outcome measurement of hand function following mirror therapy for stroke rehabilitation: A systematic review.
Cantero-Téllez R, Naughton N, Algar L, Valdes K.
J Hand Ther. 2019 Apr - Jun;32(2):277-291.e1. doi: 10.1016/j.jht.2018.01.009. Epub 2018 Mar 1.

An overview of robotic/mechanical devices for post-stroke thumb rehabilitation.
Suarez-Escobar M, Rendon-Velez E.
Disabil Rehabil Assist Technol. 2018 Oct;13(7):683-703. doi: 10.1080/17483107.2018.1425746. Epub 2018 Jan 15.

A systematic review and meta-analysis on the use of repetitive transcranial magnetic stimulation for spasticity post stroke.
McIntyre A, Mirkowski M, Thompson S, Burhan AM, Miller T, Teasell R.
PM R. 2018 Mar;10(3):293-302. doi: 10.1016/j.pmrj.2017.10.001. Epub 2017 Oct 16.

Somatosensory stimulation to improve hand and upper limb function after stroke-a systematic review with meta-analyses.
Grant VM, Gibson A, Shields N.
Top Stroke Rehabil. 2018 Mar;25(2):150-160. doi: 10.1080/10749357.2017.1389054. Epub 2017 Oct 20.

Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: a systematic review and meta-analysis.
Peng L, Zhang C, Zhou L, Zuo HX, He XK, Niu YM.
Clin Rehabil. 2018 Apr;32(4):429-439. doi: 10.1177/0269215517729528. Epub 2017 Sep 13.

Mirror therapy for motor function of the upper extremity in patients with stroke: A meta-analysis.
Zeng W, Guo Y, Wu G, Liu X, Fang Q.
J Rehabil Med. 2018 Jan 10;50(1):8-15. doi: 10.2340/16501977-2287.

Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors.
Pérez-Cruzado D, Merchán-Baeza JA, González-Sánchez M, Cuesta-Vargas AI.
Aust Occup Ther J. 2017 Apr;64(2):91-112. doi: 10.1111/1440-1630.12342. Epub 2016 Dec 29

Effects of robot-assisted therapy for the upper limb after stroke.
Veerbeek JM, Langbroek-Amersfoort AC, van Wegen EE, Meskers CG, Kwakkel G.
Neurorehabil Neural Repair. 2017 Feb;31(2):107-121. doi: 10.1177/1545968316666957. Epub 2016 Sep 24.

Interactive wearable systems for upper body rehabilitation: a systematic review.
Wang Q, Markopoulos P, Yu B, Chen W, Timmermans A.
J Neuroeng Rehabil. 2017 Mar 11;14(1):20. doi: 10.1186/s12984-017-0229-y.

Upper limb outcome measures used in stroke rehabilitation studies: a systematic literature review.
Santisteban L, Térémetz M, Bleton JP, Baron JC, Maier MA, Lindberg PG.
PLoS One. 2016 May 6;11(5):e0154792. doi: 10.1371/journal.pone.0154792. eCollection 2016.

Systematic literature review of abobotulinumtoxinA in clinical trials for adult upper limb spasticity.
Dashtipour K, Chen JJ, Walker HW, Lee MY.
Am J Phys Med Rehabil. 2015 Mar;94(3):229-38. doi: 10.1097/PHM.0000000000000208.

How do somatosensory deficits in the arm and hand relate to upper limb impairment, activity, and participation problems after stroke? A systematic review.
Meyer S, Karttunen AH, Thijs V, Feys H, Verheyden G.
Phys Ther. 2014 Sep;94(9):1220-31. doi: 10.2522/ptj.20130271. Epub 2014 Apr 24.

Upper limb casting in stroke rehabilitation: rationale, options, and techniques.
Flinn SR, Craven K.
Top Stroke Rehabil. 2014 Jul-Aug;21(4):296-302. doi: 10.1310/tsr2104-296.

Effects of repetitive transcranial magnetic stimulation on hand function recovery and excitability of the motor cortex after stroke: a meta-analysis.
Le Q, Qu Y, Tao Y, Zhu S.
Am J Phys Med Rehabil. 2014 May;93(5):422-30. doi: 10.1097/PHM.0000000000000027.

OnabotulinumtoxinA muscle injection patterns in adult spasticity: a systematic literature review.
Nalysnyk L, Papapetropoulos S, Rotella P, Simeone JC, Alter KE, Esquenazi A.
BMC Neurol. 2013 Sep 8;13:118. doi: 10.1186/1471-2377-13-118.

Treatment with botulinum toxin improves upper-extremity function post stroke: a systematic review and meta-analysis.
Foley N, Pereira S, Salter K, Fernandez MM, Speechley M, Sequeira K, Miller T, Teasell R.
Arch Phys Med Rehabil. 2013 May;94(5):977-89. doi: 10.1016/j.apmr.2012.12.006. Epub 2012 Dec 19.

Motor training programs of arm and hand in patients with MS according to different levels of the ICF: a systematic review.
Spooren AI, Timmermans AA, Seelen HA.
BMC Neurol. 2012 Jul 2;12:49. doi: 10.1186/1471-2377-12-49.

Robot-mediated upper limb physiotherapy: review and recommendations for future clinical trials.
Péter O, Fazekas G, Zsiga K, Dénes Z.
Int J Rehabil Res. 2011 Sep;34(3):196-202. doi: 10.1097/MRR.0b013e328346e8ad.

Constraint-induced movement therapy for rehabilitation of arm dysfunction after stroke in adults: an evidence-based analysis.
Medical Advisory Secretariat, Health Quality Ontario.
Ont Health Technol Assess Ser. 2011;11(6):1-58. Epub 2011 Nov 1.

The effect of upper limb orthotics after stroke: a systematic review.
Tyson SF, Kent RM.
NeuroRehabilitation. 2011;28(1):29-36. doi: 10.3233/NRE-2011-0629.


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Centre for Evidence Based Hand Surgery

The University of Nottingham
C Floor, West Block, QMC
Nottingham, NG7 2UH

telephone: +44 (0) 115 823 1115