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Hybrid Serial Casting for Children with Idiopathic Toe Walking: Safety and Effectiveness
Lori Grisez1, Catie Christensen, E Rhiannon Reid
1Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio (Grisez, Christensen, Reid, Keener, Campbell, Reader); Nisonger Center, The Ohio State University, Columbus, Ohio (Grisez).
Purpose:
Determine the safety and effectiveness of hybrid serial casting (fiberglass and soft casting tape) to increase ankle dorsiflexion passive range of motion (ADF PROM) in children with idiopathic toe walking (ITW).
Methods:
A retrospective cohort study of 65 children with ITW undergoing ankle hybrid serial casting was completed. Casts were applied weekly until age-based ADF PROM was achieved.
Results:
Children were casted an average of 3.8 weeks on the left leg and 3.1 weeks on the right. ADF PROM significantly improved from -0.3° (SD: 7.1) to 18.0° (SD: 5.6) on the left and 0.2° (SD: 8.7) to 18.4° (SD: 5.3) on the right. 5.0% of casts were removed early. Skin irritation caused a 1-week pause in casting in 6.2% of children.
Conclusion:
Hybrid serial casting may be a safe and effective method to improve ADF PROM for ITW and offers the advantage of removal without a cast saw.
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