Serial night casting increases ankle dorsiflexion range in children and young adults with Charcot-Marie-Tooth disease: a randomised trial.
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.
Rose
Kristy J
KJ
Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia. KristyR2@chw.edu.au
Raymond
Jacqueline
J
Refshauge
Kathryn
K
North
Kathryn N
KN
Burns
Joshua
J
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