What is Serial Casting?
- Serial casting is a process where a therapist applies a “series” of casts weekly to a specific joint with limited range of motion
- Each cast is applied to the joint in a stretched position, with each week providing a slightly great stretch, until the desired range of motion is achieved
Who could benefit from serial casting?
- Serial casting is beneficial to patients with a moderate to severe joint contracture
- Diagnoses often treated with casting include (but are not limited to)
- Increased muscle tone/spasticity of a joint
- Status post injury or surgery with a joint contracture
- History of toe walking that has not responded to conservative treatments
What does the casting process look like?
- A physical referral and PT evaluation are needed to begin
- Risks and benefits are assessed
- Range of motion of the affected joint is obtained
- Orthotics for post casting are often necessary and discussed with families to maintain the newly achieved range of motion
- Joint/extremity is prepped with padding and barrier cream to protect the skin
- Casts are applied with patient either lying or sitting in a held position
- One therapist will apply the cast while another will hold the joint in the specific position
How long does casting take?
- If casting is appropriate, improvement should be seen with each week of casting, at least 3-5 degrees of improvement per cast is the goal (this may vary significantly)
- When casts have achieved the desired range or motion or plateaued with progress for 2+ weeks in a row, casting is discontinued
- This total casting takes between 4-6 weeks on average (but can vary based off of joint casted)
Precautions/Limitations
- Patients being casted must be able to verbalized pain
- Casts must remain dry the entire week (no bathing)
- Never put anything in or on the cast during the week
Who will be serial casting?
Laurel Mogensen (Pineville Location)
- Pediatric PT with more than 12 years of serial casting in Charlotte
Gail Fennimore (Midtown Location)
- Pediatric PT who has been with CF&D since 1994
