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Open Access Research article

Use of a static progressive stretch orthosis to treat post-traumatic ankle stiffness

Christopher R Costa1, Mark J McElroy1, Aaron J Johnson1, Bradley M Lamm2 and Michael A Mont13*

Author Affiliations

1 Center for Joint Preservation and Replacement at the Rubin Institute for Advanced Orthopedics, Baltimore, Maryland, USA

2 International Center for Limb Lengthening at the Rubin Institute for Advanced Orthopedics, Baltimore, Maryland, USA

3 Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, Maryland, 21215, USA

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BMC Research Notes 2012, 5:348  doi:10.1186/1756-0500-5-348

Published: 4 July 2012

Abstract

Background

Chronic ankle stiffness can develop for numerous reasons after traumatic injury, and may adversely affect patient gait, mobility, and function. Although standard physical therapeutic techniques typically resolve this stiffness, some cases may be recalcitrant to these measures, making it difficult to restore range-of-motion. The purpose of this study was to evaluate a static progressive stretch orthosis for the treatment of chronic ankle stiffness.

Methods

Twenty-six patients (26 ankles) who had chronic post-traumatic ankle stiffness were studied. The patients began treatment at a mean of 47 weeks (range, 6 to 272 weeks) following their initial injury using a static progressive stretch orthosis. A patient-directed protocol was used for 30 minutes per day, 1 to 3 times per day, until the range-of-motion was considered to have plateaued. Mean treatment time was 10 weeks (range, 3 to 19 weeks). Treatment duration, range-of-motion, and complications with the device were assessed.

Results

The overall mean improvement in motion (combined dorsiflexion and plantar flexion) was 17 degrees (range, 2 to 44 degrees). There was a mean improvement in dorsiflexion of 9 degrees (range, -2 to 20 degrees), and a mean improvement of 8 degrees of plantar flexion (range, -10 to 35 degrees). There were no reports of numbness or skin problems.

Conclusions

The outcomes of this study suggest that a patient-directed treatment protocol using a static progressive stretch orthosis was an effective ancillary method for the treatment of chronic post-traumatic ankle stiffness that was refractory to standard physical therapy techniques.

Keywords:
Ankle; Stiffness; Orthosis; Progressive stress relaxation; Rehabilitation