title: Serial night casting increases ankle dorsiflexion range in children and young adults with Charcot-Marie-Tooth disease: a randomised trial.
abstract: OBJECTIVE
  Does 4 weeks of serial night casting followed by 4 weeks of stretching of the gastrocnemius and soleus improve ankle dorsiflexion range and other outcomes compared with no intervention in children and young adults with Charcot-Marie-Tooth disease?
  
  
  METHODS
  Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.
  
  
  METHODS
  30 children and young adults with Charcot-Marie-Tooth disease and restricted ankle dorsiflexion range.
  
  
  METHODS
  The experimental group received 4 weeks of serial night casting followed by 4 weeks of weightbearing stretches. The control group received no intervention.
  
  
  METHODS
  Primary outcome was ankle dorsiflexion range; secondary outcomes included foot deformity, mobility, balance, falls, and self-reported activity limitations. Outcomes were measured at baseline, 4, and 8 weeks.
  
  
  RESULTS
  By 4 weeks, serial night casting had increased ankle dorsiflexion range by a mean of 4 deg (95% CI 2 to 6) more in the experimental group than the control group. After a further 4 weeks of weightbearing stretches, the experimental group still had a mean of 3 deg (95% CI 0 to 5) more ankle dorsiflexion range than the control group. Other than reduced time to walk 10 metres at self-selected pace favouring night casting at 4 weeks, outcomes did not differ between groups at any time point. Two minor adverse events were reported in the experimental group.
  
  
  CONCLUSIONS
  4 weeks of serial night casting increased ankle dorsiflexion range compared with no intervention, but at 8 weeks there was no significant difference between groups.
authors.affiliation: Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia. KristyR2@chw.edu.au
authors.forename: Kristy J
authors.initials: KJ
authors.lastname: Rose
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Raymond
authors.forename: Kathryn
authors.initials: K
authors.lastname: Refshauge
authors.forename: Kathryn N
authors.initials: KN
authors.lastname: North
authors.forename: Joshua
authors.initials: J
authors.lastname: Burns
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D000843:Ankle Joint / Q000503:physiopathology*; D002607:Charcot-Marie-Tooth Disease / Q000503:physiopathology* / Q000534:rehabilitation*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D052580:Muscle Stretching Exercises; D016059:Range of Motion, Articular / Q000502:physiology*; D013165:Splints; D016896:Treatment Outcome; D055815:Young Adult