Passive standing may be provided to treat spasticity in people with SCI.
Passive standing (v no intervention) on spasticity in people with SCI | |||||||
---|---|---|---|---|---|---|---|
P | People with SCI | Evidence recommendation No evidence recommendation Reason: No recommendation due to insufficient or inconclusive evidence. | Weak opinion statement FOR Passive standing may be provided to treat spasticity in people with SCI. |
||||
I | Passive standing | ||||||
C | No intervention | Consensus-based opinion statement Weak for (100%) |
|||||
O | Spasticity | ||||||
SUMMARY | 1 RCT (see reference) | Mean difference (95% CI): Spasticity on the Spinal Cord Injury Spasticity Evaluation Tool 0.1 (-0.3 to 0.1) Favours no intervention |
|||||
GRADE Very low certainty ⨁◯◯◯ | Risk of bias Serious | Inconsistency Serious | Imprecision No serious | Indirectness Serious | Publication bias Serious |
||
PASSIVE STANDING ON SPASTICITY: GRADE Evidence to Decision | ||||||
---|---|---|---|---|---|---|
PROBLEM | No | Probably no | Probably yes | Yes | Don't know | |
DESIRABLE EFFECTS | Trivial | Small | Moderate | Large | Don't know | |
UNDESIRABLE EFFECTS | Large | Moderate | Small | Trivial | Don't know | |
CERTAINTY OF EVIDENCE | Very low | Low | Moderate | High | No included studies | |
HOW MUCH PEOPLE VALUE THE MAIN OUTCOME | Important uncertainty or variability | Possibly important uncertainty or variability | Probably no important uncertainty or variability | No important uncertainty or variability | ||
BALANCE OF EFFECTS | Favours the Control | Probably favours the Control | Does not favour either the intervention (I) or the comparison (C) | Probably favours the I | Favours the I | Don't know |
RESOURCES REQUIRED | Large costs | Moderate costs | Negligible costs and savings | Moderate savings | Large savings | Don't know |
CERTAINTY OF EVIDENCE OF REQUIRED RESOURCES | Very low | Low | Moderate | High | No included studies | |
COST EFFECTIVENESS | Favours the comparison | Probably favours the comparison | Does not favour either the intervention or the comparison | Probably favours the intervention | Favours the intervention | No included studies |
EQUITY | Reduced | Probably reduced | Probably no impact | Probably increased | Increased | Don't know |
ACCEPTABILITY | No | Probably no | Probably yes | Yes | Don't know | |
FEASIBILITY | No | Probably no | Probably yes | Yes | Don't know |
PASSIVE STANDING ON SPASTICITY: Randomised Controlled Trial Details | ||||||
---|---|---|---|---|---|---|
STUDY | COMPARISON | DOSAGE/DETAILS | PARTICIPANTS | N (Rx/C) | OUTCOME | ROB 2 PEDRo |
KWOK 2005 | Passive standing (and usual care) V Usual care | Tilt-table standing 5 x per week for 6 weeks (30 mins) | C5-T7 wheelchair dependent people with SCI | 17/17 | Spinal Cord Injury Spasticity Evaluation tool | Low Risk of Bias PEDro = 8/10 |
The Australian and NZ SCI Physiotherapy guideline committee recommends passive standing to treat spasticity in people with SCI. This is a consensus-based opinion statement supported by the opinions of the experts. There are no randomized controlled trials on this topic. The guideline states:
Passive standing may be provided to treat spasticity in people with SCI.
This statement was formed by considering the opinions of the experts alongside other factors. The other factors that were considered were benefits and harms, values and preferences, resource use, equity, accessibility, and feasibility.
This is a consensus-based opinion statement. Consensus-based opinion statements are less robust than evidence-based recommendations. They can be strong or weak. This is a weak consensus-based opinion statement which means that the guideline panel is confident they can probably recommend passive standing to treat spasticity in people with SCI based on opinion.
To learn more about this recommendation go to the research summary.
-
Kwok, S., Harvey, L., Glinsky, J. et al. Does regular standing improve bowel function in people with spinal cord injury? A randomised crossover trial 2015. Spinal Cord 53, 36–41.