A randomized trial assessing the effects of 4 weeks of daily stretching on ankle mobility in patients with spinal cord injuries

Objective: To determine the effect of 4 weeks of 30 minutes of daily stretching on ankle mobility in patients with recent spinal cord injuries (SCIs). Design: Assessor-blinded randomized controlled trial. Setting: Two spinal injury units in Sydney, Australia. Patients: Consecutive sample of 14 recently injured patients with paraplegia and quadriplegia. Intervention: Treated ankles were stretched continuously into dorsiflexion with a torque of 7.5N.m for 30 minutes each weekday for 4 weeks. Contralateral ankles received no stretches. Main Outcome Measures: Passive torque-angle curves for both ankles were obtained at study commencement, then at weeks 2, 4, and 5 (ie, during, at the end of, and 1 week after the stretching program). Torque-angle measurements were obtained with the knee extended and flexed. Mean values for parameters (baseline angle, angle at 10N.m, slope) describing the characteristics of the torque-angle curves were derived for each knee position. Changes from pretest to each subsequent test were calculated, as well as 95% confidence intervals (CIs) for differences in these changes between stretched and controlled ankles. Results: The stretching intervention did not significantly change any of the 3 parameters describing the torque-angle curves of the ankle in either knee position. At the beginning of the study, the mean (+/-SD) angles obtained with the application of a standardized torque with the knee extended for the control and stretch ankles were 105 degrees (+/- 10.4 degrees) and 106 degrees (+/- 9.8 degrees), respectively. After 4 weeks, these values were 106 degrees (+/- 10.6 degrees) and 107 degrees (+/- 10.6 degrees) (mean difference in change of angle = 0 degrees; 95% CI, -3.3 degrees to 3.30). Conclusion: Thirty minutes of daily stretching for 4 weeks does not significantly change ankle mobility in recently injured patients with SCIs.