The experimental group received bilateral below-knee fibreglass casts which were bi-valved to allow them to be applied each night. After two weeks, new night casts were made to ensure the dorsiflexion

stretch was maintained. At four weeks, the participants ceased wearing the casts and started Ion Channel Ligand Library ic50 a 4-week stretching program consisting of standing stretches for the gastrocnemius and soleus. The control group received no intervention for the 8 weeks. All outcomes were measured at baseline, 4, and 8 weeks by an assessor who was blinded to group allocation. Since participants in the experimental group wore the casts at night only, outcome measurement did not take place immediately after cast removal. Typically, participants were measured in the afternoon buy Cyclopamine following school, work, or university. To maintain blinding, participants and their caregivers were instructed not to inform the assessor to which group they had been allocated. The treating physiotherapist also requested that participants in the experimental group not bring their casts with them to the study visits. Children and adolescents were included if they: were aged between 7 and 20 years; had a confirmed diagnosis

of any type of Charcot-Marie-Tooth disease (either by genetic testing or a confirmed genetic test in a first or second degree relative); had a consistent clinical phenotype; had confirmatory electrophysiological testing; had restricted ankle dorsiflexion range in one or both ankles (≤ 25 deg measured using the weightbearing Lunge Test, Bennell et al 1999). They were excluded if they: had sustained an ankle sprain or fracture in the past three months; had undergone

foot or ankle surgery; were enrolled in another trial; or had participated in a stretching program in the past two months. The experimental group received 4 weeks of night casting followed by four weeks of stretching. Bilateral below-knee fibreglass night casts were made from Dynacast Pa by an Adenylyl cyclase experienced paediatric physiotherapist. The casts were applied with the participants in prone with their knee flexed to 90 deg and their ankle in neutral supinationpronation and maximum passive dorsiflexion. To ensure this range was maintained during the casting procedure, an experienced casting assistant held the limb while the treating physiotherapist applied the casting materials. When dry, the casts were bi-valved with a plaster saw and secured firmly to the limb with Velcro straps. Participants (and their caregivers) were instructed that the casts were to be worn while sleeping every night. No specific instructions were given regarding leg position during sleeping. New casts were made after two weeks to ensure that the stretch was maintained in the event of improved dorsiflexion range.