title: A randomized trial assessing the effects of 4 weeks of daily stretching on ankle mobility in patients with spinal cord injuries.
abstract: OBJECTIVE
  To determine the effect of 4 weeks of 30 minutes of daily stretching on ankle mobility in patients with recent spinal cord injuries (SCIs).
  
  
  METHODS
  Assessor-blinded randomized controlled trial.
  
  
  METHODS
  Two spinal injury units in Sydney, Australia.
  
  
  METHODS
  Consecutive sample of 14 recently injured patients with paraplegia and quadriplegia.
  
  
  METHODS
  Treated ankles were stretched continuously into dorsiflexion with a torque of 7.5 N x m for 30 minutes each weekday for 4 weeks. Contralateral ankles received no stretches.
  
  
  METHODS
  Passive torque-angle curves for both ankles were obtained at study commencement, then at weeks 2, 4, and 5 (ie, during, at the end of, and 1 week after the stretching program). Torque-angle measurements were obtained with the knee extended and flexed. Mean values for parameters (baseline angle, angle at 10 N x m, slope) describing the characteristics of the torque-angle curves were derived for each knee position. Changes from pretest to each subsequent test were calculated, as well as 95% confidence intervals (CIs) for differences in these changes between stretched and controlled ankles.
  
  
  RESULTS
  The stretching intervention did not significantly change any of the 3 parameters describing the torque-angle curves of the ankle in either knee position. At the beginning of the study, the mean (+/-SD) angles obtained with the application of a standardized torque with the knee extended for the control and stretch ankles were 105 degrees (+/- 10.4 degrees) and 106 degrees (+/- 9.8 degrees), respectively. After 4 weeks, these values were 106 degrees (+/- 10.6 degrees) and 107 degrees (+/- 10.6 degrees) (mean difference in change of angle = 0 degrees; 95% CI, -3.3 degrees to 3.3 degrees).
  
  
  CONCLUSIONS
  Thirty minutes of daily stretching for 4 weeks does not significantly change ankle mobility in recently injured patients with SCIs.
authors.affiliation: School of Physiotherapy, University of Sydney, Lidcombe, New South Wales, Australia.
authors.forename: L A
authors.initials: LA
authors.lastname: Harvey
authors.forename: J
authors.initials: J
authors.lastname: Batty
authors.forename: J
authors.initials: J
authors.lastname: Crosbie
authors.forename: S
authors.initials: S
authors.lastname: Poulter
authors.forename: R D
authors.initials: RD
authors.lastname: Herbert
mesh_terms: D000328:Adult; D000843:Ankle Joint; D001696:Biomechanical Phenomena; D003286:Contracture / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010264:Paraplegia / Q000150:complications / Q000534:rehabilitation*; D011782:Quadriplegia / Q000150:complications / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D012046:Rehabilitation / Q000379:methods; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D018709:Statistics, Nonparametric; D019415:Torque