Moseley, A. M., Herbert, R. D., Nightingale, E. J., Taylor, D. A., Evans, T. M., Robertson, G. J., Gupta, S. K., & Penn, J.(2005). Passive stretching does not enhance outcomes in patients with plantar flexion contracture after cast immobilization for ankle fracture: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 86(6), 1118-1126.

This study compared the efficacy of short- and long-duration passive stretches with a control treatment for the management of plantar flexion contracture after cast immobilization for ankle fracture. Adults (N=150) with plantar flexion contracture after cast immobilization for ankle fracture served as Ss. All subjects were weight bearing or partial weight bearing. Interventions consisted of exercise plus short-duration passive stretch, and exercise plus long-duration passive stretch. Ss underwent a 4-week course of exercises. Ss in the short-duration stretch plus exercise group completed 6 minutes of stretching per day. Ss in the long-duration stretch plus exercise group completed 30 minutes of stretching per day. Measures on the Lower Extremity Functional Scale and passive dorsi flexion range of motion with the knee bent and straight at baseline, and at 4 weeks and 3 months post-intervention.

One hundred thirty-nine (93%) subjects completed the 4-week assessment and 134 (89%) subjects completed the 3-month assessment. There were no statistically significant or clinically important between-group differences for the primary outcomes.

Implication. The addition of passive stretching provides no benefit over exercise alone for the treatment of plantar flexion contracture after cast immobilization for ankle fracture.

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