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Night splinting does not increase ankle range of motion in people with Charcot-Marie-Tooth disease: a randomised, cross-over trial
Refshauge KM, Raymond J, Nicholson G, van den Dolder PA
Australian Journal of Physiotherapy 2006;52(3):193-199
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

QUESTION: What is the effect of wearing splints at night to stretch the plantarflexors on dorsiflexion range of motion (ROM) in people with Charcot-Marie-Tooth disease? DESIGN: Randomised, assessor-blinded, cross-over trial. Participants 14 people (1 dropout) aged 7 to 30 years with Charcot-Marie-Tooth disease type 1A and with <= 15 degrees dorsiflexion range of motion (ROM). INTERVENTION: A splint holding the ankle in maximum dorsiflexion was worn nightly on one leg for 6 weeks followed by the opposite leg for the subsequent 6 weeks. OUTCOME MEASURES: The primary outcome was dorsiflexion ROM; secondary outcomes were eversion ROM, and dorsiflexion, eversion, and inversion strength, measured before and after splinting, and three months later. RESULTS: There was no significant difference between the experimental and the control intervention in terms of ROM or strength. Wearing the splint at night increased dorsiflexion ROM by 1 degree (95% CI 0.3 to 4; p = 0.72) and eversion ROM by 1 degree (95% CI 0.1 to 3; p = 0.28) compared to not wearing the splint. Wearing the splint increased dorsiflexion strength by 41 N (95% CI 0.53 to 135; p = 0.38), reduced eversion strength by 6 N (95% CI 0.112 to 101; p = 0.92) and reduced inversion strength by 8 N (95% CI 0.110 to 95; p = 0.88) compared to not wearing the splint. CONCLUSION: Wearing night splints does not increase ankle ROM or strength in people with Charcot-Marie-Tooth disease type 1A.

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