Effect of serial casting in spastic cerebral palsy.
OBJECTIVE
Cerebral palsy (CP) is a range of non progressive syndromes of posture and motor impairment due to an insult to developing brain. Spasticity and incoordination are major causes of disability in these children which can be managed by different modalities like casting, botulinum toxin, surgery etc. Cast application in spastic equinus is a well established procedure in CP but cast application in patients of CP with bilateral involvement of hip, knee and ankle is not document.


METHODS
A study was conducted on 22 children of spastic CP in age range of 3-8 years with bilateral involvement of hip, knee and ankle in 20 cases, hip and ankle in one case and only ankle in one case. Sixty eight % children were spastic diplegics. Serial weekly cast with (11 cases) or without abductor bar (11 cases) was applied for four weeks. They were followed up variably with an average period of 7 months.


RESULTS
Significant improvement was noticed in range of motion around hip, knee and ankle which as maintained over hip and knee after average follow up. Spasticity was also reduced as measured by Modified Ashworth Scale (MAS). This ultimately improved the ambulatory status and functional ability of these children.


CONCLUSIONS
Thus serial casting is a very simple, safe and cost effective procedure which can be applied even in children with mental sub normality having all three major joints involved bilaterally.
Department of Physical Medicine and Rehabilitation, SMS Hospital, SMS Medical College, Jaipur, Rajasthan, India.
Shweta
S
Jain
Navnendra
N
Mathur
Mrinal
M
Joshi
Rajeshwari
R
Jindal
Sunil
S
Goenka
D000843:Ankle Joint / Q000503:physiopathology; D002370:Casts, Surgical; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000150:complications / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology / Q000601:surgery; D011187:Posture; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D016138:Walking