Effectiveness of a programme comprising serial casting, botulinum toxin, splinting and motor training for contracture management: a randomized controlled trial.
Clin Rehabil
; 33(6): 1035-1044, 2019 Jun.
Article
in En
| MEDLINE
| ID: mdl-30813776
ABSTRACT
OBJECTIVE:
To determine the effectiveness of a programme comprising serial casting, botulinum toxin, splinting and motor training in contracture management.DESIGN:
A randomized trial with concealed allocation and assessor blinding, a deferred treatment cross-over design within the control group, was conducted.SETTING:
Inpatient Brain Injury Unit of a rehabilitation centre.SUBJECTS:
A total of 10 patients with severe acquired brain injury (13 ankles).INTERVENTIONS:
The intervention group received botulinum toxin and then serial casting. The control group was placed on a wait list for six weeks (control phase) and then received the same interventions as the intervention group (intervention phase). Both groups received splinting and motor training following serial casting. MAINMEASURES:
The primary outcome was passive ankle dorsiflexion range. Secondary outcomes included spasticity, ankle dorsiflexor strength, Functional Independence Measure score for the walking item and walking speed.RESULTS:
The mean between-group difference for passive ankle dorsiflexion range at completion of casting was 26° (95% confidence interval (CI) 17-35); at Week 2, after casting was 24° (95% CI 14-33). The mean within-group differences for passive ankle dorsiflexion at completion of casting, Week 2 after casting and Week 8 after casting were 26° (95% CI 20-31), 26° (95% CI 18-33) and 24° (95% CI 19-30), respectively. These improvements were sustained at Week 2 and Week 8 after casting.CONCLUSIONS:
A programme for contracture management comprising serial casting, botulinum toxin, motor training and splinting can be useful in improving joint range.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Splints
/
Botulinum Toxins
/
Casts, Surgical
/
Contracture
/
Neurotoxins
Type of study:
Clinical_trials
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Clin Rehabil
Journal subject:
REABILITACAO
Year:
2019
Document type:
Article
Affiliation country:
Australia