title: Passive stretching does not enhance outcomes in patients with plantarflexion contracture after cast immobilization for ankle fracture: a randomized controlled trial.
abstract: 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.
authors.affiliation: School of Physiotherapy, University of Sydney, PO Box 170, Lidcombe NSW 1825, Sydney, Australia. amoseley@mail.usyd.edu.au
authors.forename: Anne M
authors.initials: AM
authors.lastname: Moseley
authors.forename: Robert D
authors.initials: RD
authors.lastname: Herbert
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Nightingale
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Taylor
authors.forename: Trish M
authors.initials: TM
authors.lastname: Evans
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Robertson
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Gupta
authors.forename: Julie
authors.initials: J
authors.lastname: Penn
mesh_terms: 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