Night splinting does not increase ankle range of motion in people with Charcot-Marie-Tooth disease: A randomised, cross-over trial

Abstract

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. Participant(s): 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(s): 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 RQM; secondary outcomes were eversion ROM, and dorsiflexion, eversion, and inversion strength, measured before and after splinting, and three months later. Result(s): 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 -3 to 4; p = 0.72) and eversion ROM by 1 degree (95% CI -1 to 3; p = 0.28) compared to not wearing the splint. Wearing the splint increased dorsiflexion strength by 41 N (95% CI -53 to 135; p = 0.38), reduced eversion strength by 6 N (95% CI -112 to 101; p = 0.92) and reduced inversion strength by 8 N (95% CI -110 to 95; p = 0.88) compared to not wearing the splint. Conclusion(s): Wearing night splints does not increase ankle ROM or strength in people with Charcot-Marie-Tooth disease Type 1A. Australian Physiotherapy Association 2006.