Content » Vol 47, Issue 9

Short communication

Effectiveness of a night positioning programme on ankle range of motion in patients after hemiparesis: A prospective randomized controlled pilot study

Lauren DeMeyer, Marcie Brown, Ashley Adams
Rehabilitation Hospital, New Hanover Regional Medical Center, 2131 S. 17th Street, Wilmington, NC 28401, USA. E-mail:
DOI: 10.2340/16501977-2007


Objective: To investigate the effect of night positioning on ankle motion in patients after stroke or brain injury.
Design: Prospective randomized controlled pilot study with 3 groups: bivalve cast; pressure-relieving ankle–foot orthosis; and control.
Subjects/patients: Adults (n = 46) in inpatient rehabilitation with lower extremity paresis following stroke or brain injury.
Methods: Intervention group participants wore a custom bivalve cast or pre-fabricated orthosis 8–12 h/night. The primary outcome variable was passive ankle dorsiflexion. Muscle spasticity (Modified Ashworth Scale) and functional mobility (Functional Independence Measure) were also assessed.
Results: No significant differences were found between groups for all outcome measures at the pilot sample size (p > 0. 05). Control and pressure-relieving ankle–foot orthosis groups showed improvement in ankle dorsiflexion, and the bivalve cast group demonstrated a trend toward decreased spasticity. Positioning interventions were tolerated for approximately 11 h/night. Baseline range of motion was measured and a retrospective power analysis determined that a sample size of 234 is needed for 80% power to establish significance.
Conclusion: Future research with a larger sample size is re-commended to determine significance and whether a more specific subset of patients would benefit from night positioning to maximize treatment time during daytime therapy sessions.

Lay Abstract


Do you want to comment on this paper? The comments will show up here and if appropriate the comments will also separately be forwarded to the authors. You need to login/create an account to comment on articles. Click here to login/create an account.