Nonsurgical Treatment Options for Muscle Contractures in Individuals With Neurologic Disorders: A Systematic Review With Meta-Analysis.

Most included trials did not use objective measures of muscle contractures, relying instead on standard goniometry which can be influenced by the rater. Many trials did not blind the assessor, introducing a high risk of bias. The review combined data from different joints (e.g., ankle, elbow) using absolute PROM measures, which may not be directly comparable across joints. The severity of contractures at baseline varied across studies and could not be quantified or controlled for in the analysis. Past treatment history of participants was largely unknown and could have influenced the results. Two authors of the review were also authors of included trials, though they did not extract data from those specific studies. The review focused on short-term effects (up to 1 week post-intervention), so long-term outcomes remain unclear.

The authors declared no conflicts of interest. The study did not require ethical approval as it was a review of published trials.

Do not interpret the statistically significant 3-degree improvement from stretching as a clinically meaningful gain. The authors explicitly state that an effect of less than 5 degrees is not considered clinically important, and the quality of evidence is limited by the lack of objective measurement in most trials.