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What to Expect with Serial Casting

Posted By Sheila Krahl PT, DPT

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Serial casting is the process of putting on and then taking off a cast on an arm or leg every seven days for a period of several weeks. The goal: stretching muscles to allow for better movement and range of motion over time.

Common diagnoses eligible for serial casting include: cerebral palsy, brain injury, spinal cord injury, and idiopathic toe walking. Kids who participate in serial casting typically see improvements within several weeks. For example, children receiving serial casting on their leg may transition from only walking on their toes to walking with a heel-to-toe pattern. Their balance and participation in age-appropriate functional activities (like stairs or running) may improve, too!

So, how does serial casting work?

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At the initial visit, a cast will be applied to your child. This cast will be made out of a thin sock-like material, followed by cotton wrap, foam padding, and fiberglass wrap on the outside. While it should not be painful, your child may experience some initial muscle stretch discomfort. For a period of several weeks, the cast will be changed once a week, or more frequently if needed.

While the cast is on, your child can participate in most of his/her normal activities. Walking and standing are highly encouraged! In the case of leg casts, your child will be provided with a special shoe to limit slipping and ensure ideal posture. It will be important for your child to avoid water exposure as this can cause irritation and infection.

At each follow-up appointment throughout the treatment, the cast will be removed using a special tool called a cast saw. Then, the therapist will clean your child’s leg or arm and measure how much motion has been gained. A new cast will be applied with an increased amount of stretch.

If your child requires new orthotics, this can be coordinated with RIC’s Prosthetics &Orthotic Clinical Center. That way, he/she can transition smoothly from casts to orthotics without losing any range of motion.

The entire casting process can take anywhere from 4 - 12 weeks, depending on your child’s progress. Your therapist will be able to update you weekly on how quickly your child is progressing toward his/her range of motion goal.

Do you think your child could benefit? Do you want more information? Please call the Pediatric Outpatient Therapy Department at 312-238-1139

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