A randomized trial assessing the effects of 4 weeks of daily stretching on ankle mobility in patients with spinal cord injuries

Harvey LA, Batty J, Crosbie J, Poulter S, Herbert RD. A randomized trial assessing the effects of 4 weeks of daily stretching on ankle mobility in patients with spinal cord injuries. Arch Phys Med Rehabil 2000;81:1340-7. Objective: To determine the effect of 4 weeks of 30 minutes of daily stretching on ankle mobility in patients with recent spinal cord injuries (SCIs). Design: Assessor-blinded randomized controlled trial. Setting: Two spinal injury units in Sydney, Australia. Patients: Consecutive sample of 14 recently injured patients with paraplegia and quadriplegia. Intervention: Treated ankles were stretched continuously into dorsiflexion with a torque of 7.5N·m for 30 minutes each weekday for 4 weeks. Contralateral ankles received no stretches. Main Outcome Measures: Passive torque-angle curves for both ankles were obtained at study commencement, then at weeks 2, 4, and 5 (ie, during, at the end of, and 1 week after the stretching program). Torque-angle measurements were obtained with the knee extended and flexed. Mean values for parameters (baseline angle, angle at 10N·m, slope) describing the characteristics of the torque-angle curves were derived for each knee position. Changes from pretest to each subsequent test were calculated, as well as 95% confidence intervals (CIs) for differences in these changes between stretched and controlled ankles. Results: The stretching intervention did not significantly change any of the 3 parameters describing the torque-angle curves of the ankle in either knee position. At the beginning of the study, the mean (±SD) angles obtained with the application of a standardized torque with the knee extended for the control and stretch ankles were 105° (± 10.4°) and 106° (± 9.8°), respectively. After 4 weeks, these values were 106° (± 10.6°) and 107° (± 10.6°) (mean difference in change of angle = 0°; 95% CI, − 3.3° to 3.3°). Conclusion: Thirty minutes of daily stretching for 4 weeks does not significantly change ankle mobility in recently injured patients with SCIs. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation