The effect of casting combined with stretching on passive ankle dorsiflexion in adults with traumatic head injuries.
OBJECTIVE
Ankle plantar-flexion contractures are a common problem following traumatic head injury. Although serial casting is used to correct and prevent ankle plantar-flexion contractures, treatment efficacy has not been evaluated using an experimental design. The aim of this research was to establish the effect of a regimen of casting combined with stretching on passive ankle dorsiflexion motion.


METHODS
Nine people who had sustained traumatic closed head injuries and had limited dorsiflexion motion participated in the study.


METHODS
A crossover design was used in the study. Subjects were assigned to both experimental and control groups. Torque-controlled measurements of passive ankle dorsiflexion motion were obtained for all subjects before and after 1 week of casting combined with stretching, as well as before and after a 1-week control period. The order of the experimental and control conditions was randomized.


RESULTS
Passive ankle dorsiflexion increased by a mean of 13.5 degrees (SD = 9.3) during the experimental condition, as compared with a mean decrease of 1.9 degrees (SD = 10.2) during the control condition. The difference between the experimental and control conditions was statistically significant.


CONCLUSIONS
These findings suggest that casting combined with stretching is an effective method of correcting ankle plantar-flexion contractures in patients with traumatic head injuries.
Moseley
A M
AM
Brain Injury Rehabilitation Unit, Liverpool Health Service, Liverpool, New South Wales, Australia. ptvmoseley@cchs.usyd.edu.au
D000293:Adolescent; D000328:Adult; D000842:Ankle; D002370:Casts, Surgical; D003286:Contracture / Q000209:etiology / Q000517:prevention & control*; D006259:Craniocerebral Trauma / Q000150:complications / Q000534:rehabilitation*; D018592:Cross-Over Studies; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000379:methods*; D018583:Pliability; D016059:Range of Motion, Articular