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Study flow diagram.
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Figure 1

Study flow diagram.

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies. Two studies are included in this review.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies. Two studies are included in this review.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Joint mobility—short‐term effects, Outcome 1 Spinal cord injury.
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Analysis 1.1

Comparison 1 Joint mobility—short‐term effects, Outcome 1 Spinal cord injury.

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Comparison 2 Spasticity—short‐term effects, Outcome 1 Paratonia.
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Analysis 2.1

Comparison 2 Spasticity—short‐term effects, Outcome 1 Paratonia.

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Comparison 3 Pain—short‐term effects, Outcome 1 Paratonia.
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Analysis 3.1

Comparison 3 Pain—short‐term effects, Outcome 1 Paratonia.

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Summary of findings for the main comparison. Short‐term effects on spasticity, pain and joint mobility

Short‐term effects on spasticity, pain and joint mobility

Patient or population: patients with or at risk of contractures
Settings: nursing home or community
Intervention: PMs versus no PMs

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

PMs versus no PMs

Spasticity
Tallied Modified Ashworth Scale
Follow‐up: mean 1 day

Data were not pooled

Data were not pooled

Not estimable

121
(two studies)

⊕⊝⊝⊝
very low1,2,3

Pain
Pain Assessment Checklist for Seniors With Limited Ability to Communicate Scale from: 0 to 24
Follow‐up: mean 1 day

Mean pain in control groups was
3.8 points

Mean pain in intervention groups was
0.4 higher
(0.56 lower to 1.36 higher)

Not estimable

101
(one study)

⊕⊝⊝⊝
very low1,2,3

Joint mobility
Ankle dorsiflexion range of motion. Scale from 0 to 120
Follow‐up: mean 1 day

Mean joint mobility in control groups was
12 degrees

Mean joint mobility in intervention groups was
4.05 higher
(1.65 to 6.46 higher)

Not estimable

40
(one study)

⊕⊝⊝⊝
very low1,2,3

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval.

GRADE Working Group grades of evidence.
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Consistency had been downgraded by one point because only one trial is included, and therefore the results cannot be consistent across different trials.
2Indirectness had been downgraded by one point because only one trial is included, and therefore the results cannot be generalised.
3Imprecision has been downgraded by one point because only one trial is included, and therefore the precision of the estimate from this one trial cannot be confirmed.

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Summary of findings for the main comparison. Short‐term effects on spasticity, pain and joint mobility
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Comparison 1. Joint mobility—short‐term effects

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Spinal cord injury Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected
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Comparison 1. Joint mobility—short‐term effects
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Comparison 2. Spasticity—short‐term effects

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paratonia Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
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Comparison 2. Spasticity—short‐term effects
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Comparison 3. Pain—short‐term effects

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paratonia Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
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Comparison 3. Pain—short‐term effects
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