No difference between wearing a night splint and standing on a tilt table in preventing ankle contracture early after stroke: a randomised trial

Robinson, Wendy; Smith, Robyn; Aung, Ohnmar; Ada, Louise

doi:10.1016/s0004-9514(08)70063-1

Cited by 30 publications

(36 citation statements)

References 22 publications

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“…The use of an ankle-foot orthosis (AFO) can improve gait in patients with active plantarflexion during the swing phase of gait but also may be beneficial in preventing ankle contracture. 78 For nonambulatory patients, the use of a resting ankle splint at night, set in the plantigrade position (ankle at 90° and subtalar neutral), or …”

mentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,169

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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mentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,169

840

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“…This is conservative as others set the clinically worthwhile criterion at 101. 15 Our point estimate of 41 therefore suggests a treatment effect that is too small to be worthwhile. Few would dispute the claim that 41 of ankle range of motion is of little functional importance on its own.…”

Section: Discussionmentioning

confidence: 85%

Effects of 6 months of regular passive movements on ankle joint mobility in people with spinal cord injury: a randomized controlled trial

et al. 2008

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Study design: Assessor-blinded within-subject randomized controlled trial. Objective: To determine the effects of 6 months of regular passive movements on ankle joint mobility in people with spinal cord injury. Setting: Community, Australia. Methods: A total of 20 people with tetraplegia living in the community had one ankle randomized to a control group and the other to an experimental group. Carers administered passive movements to participants' experimental ankles for 10 min, 10 times a week for 6 months. The control ankles were left untreated. The primary outcome was passive ankle dorsiflexion range of motion. Results: Adherence was high (mean adherence rate of 96%). Ankle dorsiflexion range of motion decreased by a mean (s.d.) of 21 (4) in control ankles and increased by 21 (4) in experimental ankles. The mean (95% confidence interval, CI) effect on ankle dorsiflexion range of motion was 41 (95% CI, 2-61). Conclusion: Regular passive movements have small effects on ankle joint mobility. It is unclear if these effects are clinically worthwhile.

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“…The results of the meta-analyses for interventions related to gait and mobility-related functions and activities are summarized in figure 2 (for details see table S2A in file S1). Pooling was not possible for bilateral leg training with rhythmic gait cueing [30], mirror therapy for the paretic leg [31], mental practice with motor imagery [32], limb overloading with external weights [33], systematic verbal feedback on gait speed [34], maintenance of ankle dorsiflexion by using a standing frame or night splint [35], manual passive mobilization of the ankle [36], range of motion exercises of the ankle with specially designed equipment [37], ultrasound for the paretic leg [38], segmental muscle vibration for a drop foot [39], whole body vibration [40], and wheel chair propulsion [41].…”

Section: Resultsmentioning

confidence: 99%

What Is the Evidence for Physical Therapy Poststroke? A Systematic Review and Meta-Analysis

et al. 2014

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BackgroundPhysical therapy (PT) is one of the key disciplines in interdisciplinary stroke rehabilitation. The aim of this systematic review was to provide an update of the evidence for stroke rehabilitation interventions in the domain of PT.Methods and FindingsRandomized controlled trials (RCTs) regarding PT in stroke rehabilitation were retrieved through a systematic search. Outcomes were classified according to the ICF. RCTs with a low risk of bias were quantitatively analyzed. Differences between phases poststroke were explored in subgroup analyses. A best evidence synthesis was performed for neurological treatment approaches. The search yielded 467 RCTs (N = 25373; median PEDro score 6 [IQR 5–7]), identifying 53 interventions. No adverse events were reported. Strong evidence was found for significant positive effects of 13 interventions related to gait, 11 interventions related to arm-hand activities, 1 intervention for ADL, and 3 interventions for physical fitness. Summary Effect Sizes (SESs) ranged from 0.17 (95%CI 0.03–0.70; I2 = 0%) for therapeutic positioning of the paretic arm to 2.47 (95%CI 0.84–4.11; I2 = 77%) for training of sitting balance. There is strong evidence that a higher dose of practice is better, with SESs ranging from 0.21 (95%CI 0.02–0.39; I2 = 6%) for motor function of the paretic arm to 0.61 (95%CI 0.41–0.82; I2 = 41%) for muscle strength of the paretic leg. Subgroup analyses yielded significant differences with respect to timing poststroke for 10 interventions. Neurological treatment approaches to training of body functions and activities showed equal or unfavorable effects when compared to other training interventions. Main limitations of the present review are not using individual patient data for meta-analyses and absence of correction for multiple testing.ConclusionsThere is strong evidence for PT interventions favoring intensive high repetitive task-oriented and task-specific training in all phases poststroke. Effects are mostly restricted to the actually trained functions and activities. Suggestions for prioritizing PT stroke research are given.

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No difference between wearing a night splint and standing on a tilt table in preventing ankle contracture early after stroke: a randomised trial

Cited by 30 publications

References 22 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Effects of 6 months of regular passive movements on ankle joint mobility in people with spinal cord injury: a randomized controlled trial

What Is the Evidence for Physical Therapy Poststroke? A Systematic Review and Meta-Analysis

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