Passive stretching does not enhance outcomes in patients with plantarflexion contracture after cast immobilization for ankle fracture: a randomized controlled trial.
OBJECTIVE
To compare the efficacy of short- and long-duration passive stretches with a control treatment for the management of plantarflexion contracture after cast immobilization for ankle fracture.


METHODS
Assessor-blinded, randomized controlled trial.


METHODS
Hospital physical therapy outpatient departments.


METHODS
Adults with plantarflexion contracture (N=150) after cast immobilization for ankle fracture. All subjects were weight bearing or partial weight bearing.


METHODS
Exercise only, exercise plus short-duration passive stretch, and exercise plus long-duration passive stretch. All subjects had a 4-week course of exercises. In addition, subjects in the short-duration stretch plus exercise group completed 6 minutes of stretching per day, and subjects in the long-duration stretch plus exercise group completed 30 minutes of stretching per day.


METHODS
Lower Extremity Functional Scale and passive dorsiflexion range of motion with the knee bent and straight at baseline, and at 4 weeks and 3 months postintervention.


RESULTS
One hundred thirty-nine (93%) subjects completed the 4-week assessment and 134 (89%) subjects completed the 3-month assessment. There were no statistically significant or clinically important between-group differences for the primary outcomes.


CONCLUSIONS
The addition of passive stretching confers no benefit over exercise alone for the treatment of plantarflexion contracture after cast immobilization for ankle fracture.
Moseley
Anne M
AM
School of Physiotherapy, University of Sydney, PO Box 170, Lidcombe NSW 1825, Sydney, Australia. amoseley@mail.usyd.edu.au
Herbert
Robert D
RD
Nightingale
Elizabeth J
EJ
Taylor
Deborah A
DA
Evans
Trish M
TM
Robertson
Gavin J
GJ
Gupta
Sandeep K
SK
Penn
Julie
J
D000328:Adult; D016512:Ankle Injuries / Q000628:therapy*; D002370:Casts, Surgical; D003286:Contracture / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D007103:Immobilization / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D017063:Outcome Assessment, Health Care; D026741:Physical Therapy Modalities; D016037:Single-Blind Method