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

QUESTION: Is wearing a night splint as effective as standing on a tilt table in preventing ankle dorsiflexion contracture and promoting the ability to stand up early after stroke?

DESIGN

Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.

PARTICIPANTS

30 patients undergoing rehabilitation who were not yet walking and within three weeks of their first stroke.

INTERVENTION: For four weeks, one group wore a splint with the affected ankle at plantargrade, 7 nights per week, while the other group stood on a tilt table for 30 min with the ankle at maximum dorsiflexion, 5 times per week. This was followed by a period of no intervention for six weeks. Both groups received inpatient and outpatient rehabilitation emphasising mobility.

OUTCOME MEASURES: The primary outcome was contracture measured as maximum passive ankle dorsiflexion.

RESULTS

The night splint group had the same amount of ankle dorsiflexion as the tilt table group by Week 4 (mean difference 1 deg, 95% CI -5 to 7), and by Week 10 (mean difference 3.5 deg, 95% CI -3 to 10).

CONCLUSION

When added to early rehabilitation, wearing a night splint on the affected ankle in stroke patients appears to be as effective as standing on a tilt table in preventing contracture at the ankle. However, since there was no control group, the prevention of contracture may have been due to other factors.