Article

OBJECTIVE: To investigate the effect of night positioning on ankle motion in
patients after stroke or brain injury. DESIGN: Prospective randomized controlled
pilot study with 3 groups: bivalve cast; pressure-relieving ankle-foot orthosis;
and control. PATIENTS:
Adults (n = 46) in inpatient rehabilitation with
lower extremity paresis following stroke or brain injury.
METHODS: Intervention
group participants wore a custom bivalve cast or pre-fabricated orthosis 8-12
h/night. The primary outcome variable was passive ankle dorsiflexion. Muscle
spasticity (Modified Ashworth Scale) and functional mobility (Functional
Independence Measure) were also assessed. RESULTS: No significant differences
were found between groups for all outcome measures at the pilot sample size (p >
0.05). Control and pressure-relieving ankle-foot orthosis groups showed
improvement in ankle dorsiflexion, and the bivalve cast group demonstrated a
trend toward decreased spasticity. Positioning interventions were tolerated for
approximately 11 h/night. Baseline range of motion was measured and a
retrospective power analysis determined that a sample size of 234 is needed for
80% power to establish significance. CONCLUSION: Future research with a larger
sample size is re-commended to determine significance and whether a more specific
subset of patients would benefit from night positioning to maximize treatment
time during daytime therapy sessions.

Langue : ANGLAIS