Serial casting is a non-invasive form of spasticity treatment that works to gently stretch contracted muscles over a set period of time.
This article will explain what serial casting is, and how it can help children with cerebral palsy for spasticity management.
What is Serial Casting?
Serial casting is used for children with cerebral palsy that have shortened muscles due to spasticity. When muscles stay contracted, they limit the joint’s range of motion, which results in stiff movements.
Serial casting holds the joint in place so that there is slight tension on the muscle. This tension will gradually make the muscle longer and more flexible.
It’s most commonly used for the ankle area, but can also be used for the knees, elbows, wrists, or fingers.
The goal of serial casting is to increase range of motion and lengthen contracted muscles through subtle, prolonged stretching.
Serial casting ensures that the muscle is constantly being stretched, even when your child isn’t doing anything. This is called passive stretching.
Many children with spasticity in their legs will develop an abnormal walking pattern.
Serial casting will help promote proper form so that your child isn’t walking on their toes, or with their feet pointed inward or outward.
How Long Do You Wear the Cast?
Serial casting is non-invasive, making it ideal for children.
It’s a gradual process that may provide changes for several weeks or months.
Generally, the cast is replaced every 7 days for a period of up to 12 weeks. However, the cast can be replaced slightly earlier or later depending on how severe the spasticity is.
This study suggests that changing the cast within 5 days is optimal to the traditional 7 days because it reduces the onset of complications and discontinuation.
Changing the cast more often can reduce the potential for moisture retention, which can cause skin irritations.
The cast will gently stretch the muscles, so it should not be painful and your child will be less resistant to wearing it.
As you continue to maintain a stretch, the amount of tension decreases and allows the muscle fibers to lengthen.
Therefore, each time that the cast is replaced, the muscle can be stretched further.
What to Expect After Serial Casting
Initially, the cast might feel uncomfortable. It shouldn’t be painful, but it will add extra weight to your child’s leg.
Your child should adjust to the cast quickly and be able to function as they did before they got the cast.
It’s recommended that children be active while they have the cast on because it will help them adjust to walking with improved form.
Another caution to be aware of is that areas inside the cast may get itchy.
To reduce itching, keep the cast dry. Moisture retention may cause blistering or pressure sores.
Prevent your child from sticking anything inside the cast to relieve the itchiness. This may further irritate the skin or even get stuck inside the cast.
A cast is low maintenance, but it does need to stay dry. Children will need to wrap their cast with plastic wrap, secure it with medical tape, and place a plastic bag around it when they bathe. Even though it is covered, the limb with the cast should never go in the water.
Can Serial Casting Treat Spasticity Long-Term?
The effects of serial casting are not permanent and will require maintenance after the cast is removed.
Your child’s doctor may advise wearing a brace overnight. Braces can be taken on and off throughout the day and will maintain your child’s range of motion.
As previously mentioned, serial casting may last up to 12 weeks, and the continuous stretching will lengthen the muscle fibers.
However, failure to continue stretching and exercising after the cast is removed may cause your muscles to shorten again.
It’s important to take advantage of the effects of serial casting and practice moving with correct form as much as you can to retain the improved function.
Serial Casting for Children with Cerebral Palsy
Serial casting is well-tolerated by most children because it is mild, gradual, and comes with minimal side effects if properly taken care of.
Casting will promote proper form and prevent the muscles from further tightening. Additionally, prolonged stretching will lengthen muscles to improve flexibility, range of motion, and gait.
We hope this article helped you better understand what serial casting is and how it can help individuals with cerebral palsy manage their spasticity. Good luck!
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