Serial casting involves the application of successive casts to increase soft tissue range of motion (ROM) surrounding the casted joint when increased muscle tone and spasticity is present. Casts are typically left on for 2 to 3 weeks at a time and may be successively wedged or removed entirely and re-casted in a further corrected position to lengthen the muscles. Patients and families need to be willing and able to make time for routine clinical visits to ensure treatment success.
Serial casting may be done in both the lower and upper extremities. Conditions that would benefit from serial casting include:
• Cerebral palsy
• Spinal cord injury
Numerous studies have found positive benefits associated with lower extremity serial casting, including: improved ROM, reduced tone, decreased dynamic and passive spasticity, improved ambulation, and enhanced functional status. Clinical outcomes have shown serial casting leads to fewer heel lifts on ankle-foot orthoses (AFOs), less tendon lengthening surgeries, AFOs that are easier to fit, and improved integrity of feet