Serial Casting

We first heard about serial casting during our son's month of intensive pediatric therapy. His PT told us about children they had worked with who were able to postpone or avoid surgery for muscle tightness using this approach.

Serial Casting - quoted from St. Joseph's Children's Hospital of Tampa

"Serial casting is a noninvasive procedure that helps children and adults improve their range of motion so they can perform daily activities with less difficulty. It is a process in which a well-padded cast is used to immobilize a joint that is lacking full range of motion. The cast will be applied and removed on a weekly basis. Each cast gradually increases the range of motion in the affected joint.

Who benefits from Serial Casting?
Muscle tightness can manifest itself in many ways and for various reasons. Doctors refer patients for serial casting to help improve overall quality of life. Serial casting helps patients who have a variety of disorders including:

• Cerebral palsy
• Spina bifida
• Brain or spinal cord injury
• Congenital abnormalities
• Muscular dystrophy
• Idiopathic toe walking
• Peripheral neuropathy

Why would a physician refer for Serial Casting?

• Serial casting is a non-surgical approach aimed at reducing muscle tightness around a joint that is limiting range of motion and functional mobility.
• Serial casting assists in achieving the optimum alignment of a joint. It also helps prepare a joint for the use of further orthopedic devices such as braces, splints, etc.
• Serial casting may help decrease the chance of a deformity developing and/or progressing due to abnormal weight-bearing.
• Serial casting is a safe and effective way to increase range of motion and improve functional mobility. It may help eliminate, delay, or minimize the need for surgical intervention.

What happens during a Serial Casting session?
Muscle strength and range of motion of the affected joint will be assessed prior to application of the cast. A team of specially trained therapists will apply the cast in the joint’s optimal position and range. Instruction about care of the cast and precautions will be reviewed with the family and patient.

How long will I need to come for cast changes?
Casts will be changed on a weekly basis until a target range-of-motion goal is achieved. Predicting the number of casting sessions is difficult, as each individual responds to the casting procedure at different rates. Typically, the casting procedure is completed in 4-6 weeks.

What happens after the casting is finished?
The physician determines what may be needed in terms of orthotics (braces, splints, etc.) to help maintain the newly gained range of motion.

How does Serial Casting affect the patient and family?
A short accommodation time will be required, as the cast has added weight and the joint is now immobile. A walking cast and cast shoe allow children to walk during the period of casting. Daily routines are not altered significantly and patients can stay very active, participating in school and normal activities. The biggest challenge is keeping the cast dry. Sponge bathing is necessary to avoid getting the cast wet."