For how long must the soleus muscle be stretched each day to prevent contracture?

The extent to which treatment of passive muscle contracture could be minimised without loss of efficiency was studied. Soleus muscle contracture was measured by the difference between the ankle angles at which minimal and maximal resistance occurred during slow dorsiflexion of the ankle. This examination was done twice, at the beginning and end of a seven-month observation period. During the observation period, also, the ankle angles were measured throughout a 24-hour period in the ordinary life of the child. The number of hours per 24-hour period during which the soleus muscle was stretched above a minimal threshold length was calculated. The major finding was that there was no progressive contracture when the soleus was stretched for at least six hours a day (the same time as in non-handicapped children). On the other hand, there was progressive contracture when the stretching time was as short as two hours. Two of the cases examined illustrated the possible causes of success or failure of night splints. These results provide new guidelines for the continuous treatment of children with cerebral palsy.