Effect of serial casting in spastic cerebral palsy

Area of Science:

• Pediatric Orthopedics
• Neurology
• Rehabilitation Medicine

Background:

• Cerebral palsy (CP) causes motor impairments like spasticity and incoordination, significantly impacting children's functional abilities.
• While casting is established for spastic equinus in CP, its application in cases involving multiple bilateral joints (hip, knee, ankle) is less documented.

Purpose of the Study:

• To evaluate the efficacy of serial casting in managing spasticity and improving joint mobility in children with CP affecting bilateral hips, knees, and ankles.
• To assess the impact of this intervention on ambulatory status and overall functional ability.

Main Methods:

• A study involving 22 children (ages 3-8) with spastic CP and bilateral hip, knee, and ankle involvement.
• Serial weekly casting, with or without an abductor bar, was applied for four weeks.
• Outcomes were assessed over an average follow-up period of 7 months, including range of motion and spasticity using the Modified Ashworth Scale (MAS).

Main Results:

• Significant improvements in the range of motion for hip, knee, and ankle joints were observed, with improvements maintained at the hip and knee.
• A reduction in spasticity, as measured by the Modified Ashworth Scale (MAS), was noted.
• The intervention led to enhanced ambulatory status and improved functional abilities in the participants.

Conclusions:

• Serial casting is a simple, safe, and cost-effective method for managing complex spasticity in children with CP.
• This treatment is applicable even in cases involving bilateral involvement of all three major joints (hip, knee, ankle) and in children with cognitive impairments.