The effectiveness of interventions targeting spasticity on functional clinical outcomes in patients with multiple sclerosis: a systematic review of clinical trials

Objective:This systematic review was investigating the effectiveness of interventions targeting spasticity on functional clinical outcomes patients with multiple sclerosis (pwMS). Methods:A literature search was performed in PubMed, Scopus, Web of Science, Elsevier, ProQuest, Sage Journals, Physiotherapy Evidence Database and the Cochrane Library. This systematic review included any types of clinical trial that investigate effects of the interventions targeting spasticity on functional clinical outcomes of pwMS. Results:A total of 10 studies were included in this review. Two articles investigated the effects of pharmacological interventions; one of these used Botulinum neurotoxin A (BONT-A), and the other one used cannabis cigarettes. Eight articles examined the effects of non-pharmacological interventions; six of these used exercise therapy one of these used vibration therapy and the remaining one used cold therapy. Outcomes related to spasticity, functional status, pain and quality of life were reported. One of two articles examining pharmacological interventions reported significant improvement in spasticity and functional outcomes. Two of eight articles examining non-pharmacological interventions reported significant improvement in spasticity, functional and pain outcomes. Conclusions:There is limited evidence for the beneficial effects of interventions targeting spasticity on functional clinical outcomes in pwMS. Therefore, more high quality randomised clinical trial is needed to determine the effectiveness of different kinds of spasticity managements interventions on functional outcomes in pwMS.