@article{22883,
  keywords = {Adult, Female, Humans, Male, Treatment Outcome, Middle Aged, Physical Therapy Modalities, Contracture, Patient Compliance, Outcome Assessment (Health Care), Disease Management, Posture, Brain Injuries, Walking, Combined Modality Therapy, Electric Stimulation Therapy, Foot, Splints, Tilt-Table Test},
  author = {Harvey Lisa and Moseley Anne and Leung Joan and Whiteside Bhavini and Simpson Melissa and Stroud Katarina},
  title = {Standing with electrical stimulation and splinting is no better than standing alone for management of ankle plantarflexion contractures in people with traumatic brain injury: a randomised trial.},
  abstract = {<p>
<b>QUESTION: </b>Is a combination of standing, electrical stimulation and splinting more effective than standing alone for the management of ankle contractures after severe brain injury?
</p>

<p>
<b>DESIGN: </b>A multi-centre randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis.
</p>

<p>
<b>PARTICIPANTS: </b>Thirty-six adults with severe traumatic brain injury and ankle plantarflexion contractures.
</p>

<p>
<b>INTERVENTION: </b>All participants underwent a 6-week program. The experimental group received tilt table standing, electrical stimulation and ankle splinting. The control group received tilt table standing alone.
</p>

<p>
<b>OUTCOME MEASURES: </b>The primary outcome was passive ankle dorsiflexion with a 12Nm torque. Secondary outcomes included: passive dorsiflexion with lower torques (3, 5, 7 and 9Nm); spasticity; the walking item of the Functional Independence Measure; walking speed; global perceived effect of treatment; and perceived treatment credibility. OUTCOME MEASURES were taken at baseline (Week 0), end of intervention (Week 6), and follow-up (Week 10).
</p>

<p>
<b>RESULTS: </b>The mean between-group differences (95% CI) for passive ankle dorsiflexion at Week 6 and Week 10 were -3 degrees (-8 to 2) and -1 degrees (-6 to 4), respectively, in favour of the control group. There was a small mean reduction of 1 point in spasticity at Week 6 (95% CI 0.1 to 1.8) in favour of the experimental group, but this effect disappeared at Week 10. There were no differences for other secondary outcome measures except the physiotherapists' perceived treatment credibility.
</p>

<p>
<b>CONCLUSION: </b>Tilt table standing with electrical stimulation and splinting is not better than tilt table standing alone for the management of ankle contractures after severe brain injury.
</p>

<p>
<b>TRIAL REGISTRATION: </b>ACTRN12608000637347. [Leung J, Harvey LA, Moseley AM, Whiteside B, Simpson M, Stroud K (2014) Standing with electrical stimulation and splinting is no better than standing alone for management of ankle plantarflexion contractures in people with traumatic brain injury: a randomised trial.Journal of Physiotherapy60: 201-208].
</p>
},
  year = {2014},
  journal = {J Physiother},
  volume = {60},
  pages = {201-8},
  issn = {1836-9561},
  doi = {10.1016/j.jphys.2014.09.007},
  language = {eng},
}