Study concept and design: Whiting, Wolff, Misso, Kleijnen.
Acquisition, analysis, or interpretation of data: Whiting, Wolff, Deshpande, Di Nisio, Duffy, Hernandez, Keurentjes, Lang, Misso, Ryder, Schmidlkofer, Westwood.
Drafting of the manuscript: Whiting, Keurentjes, Ryder.
Critical revision of the manuscript for important intellectual content: Whiting, Wolff, Deshpande, Di Nisio, Duffy, Hernandez, Keurentjes, Lang, Misso, Ryder, Schmidlkofer, Westwood, Kleijnen.
Statistical analysis: Whiting, Wolff, Di Nisio, Hernandez, Keurentjes, Schmidlkofer.
Obtained funding: Kleijnen.
Administrative, technical, or material support: Deshpande, Lang, Ryder.
Study supervision: Whiting, Kleijnen.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and declare support from the Swiss Federal Office of Public Health (FOPH) for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities that could appear to have influenced the submitted work. Dr Whiting reports that part of her time on this review was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS (National Health Service) Foundation Trust. No additional disclosures were reported.
Funding/Support: This funded by the Swiss Federal Office of Public Health (FOPH) under grant agreement 14.001443/204.0001/-1257.
Role of the Funder/Sponsor: The FOPH had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The decision to submit the article for publication was a condition of the funding and was made before any results were available.
Additional Author Contributions: Dr Whiting drafted the article, produced tables and figures and performed the analysis. Drs Whiting, Wolff, and Kleijnen and Ms Misso and Mr Duffy drafted the protocol. Mr Duffy and Ms Misso conducted the literature searches. Drs Whiting, Wolff, and Lang screened searched results and selected full-text studies for inclusion. Drs Whiting, Wolff, Lang, Westwood, Keurentjes, Di Nisio, Hernandez, and Messrs Deshpande and Ryder, and Ms Schmidlkofer performed data extraction and risk-of-bias assessment. Dr Wolff performed the GRADE assessments. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Disclaimer: The views expressed are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health.
Additional Contributions: We would like to thank Julie Harker (MRes, Kleijnen Systematic Reviews at the time of this project) for help with inclusion screening and data extraction and Gillian Worthy (MSc, Kleijnen Systematic Reviews) for advice on data analysis. Neither of these individuals received additional compensation in association with their work on this article.
Correction: This article was corrected online June 26, 2015, for incorrect axis labeling in Figure 4; on July 13, 2015, for a corrected average reduction to the Ashworth spasticity scale (as reported in the Abstract); on November 5, 2015, for an incorrect nonproprietary name and approved use for a drug in Table 1; and on April 12, 2016, for an incorrect effect estimate.