Serial casting versus stretching technique to treat knee flexion contracture in children with spina bifida: a comparative study.
BACKGROUND
Severe knee contractures that develop soon after muscle imbalance may not improve with stretching exercises and splinting. An alternative treatment is serial casting, which has been used to promote increased range of motion.


OBJECTIVE
The purpose of this study was to compare the effectiveness of using serial casting and passive stretching approaches to treat knee flexion contracture in children with spina bifida.


METHODS
In a pre/post randomized controlled study, ten participants were included in the serial casting group, while eight participants were included in the passive stretching intervention group. The degree of knee extension was measured at baseline, immediately after intervention, and at a one-year follow-up using a standard goniometer.


RESULTS
Both groups showed significant improvements in the degree of flexion contracture at the post-treatment evaluation and the follow-up evaluation. The serial casting group showed significant improvements in knee flexion contracture at the post-treatment evaluation, t (9)=13.4, p < 0.001, and the one-year follow-up evaluation, t (9) = 7.46, p < 0.001. The passive stretching group also showed significant improvements in knee flexion contracture at the post-treatment evaluation, t (7) =2.6, p < 0.05, and the one-year follow-up evaluation, t (7) = 3.6, p < 0.05. However, statistically significant improvements in the serial casting group compared with passive stretching group in relation to the degree of flexion contracture were found at the immediate post-treatment evaluation, F(1, 15)=246, p=0.0001, and the one-year follow-up evaluation, F (1, 15)=51.5, p=0.0001.


CONCLUSIONS
The outcomes of this study provide the first evidence that serial casting may be a useful intervention in treating knee flexion contracture in children with spina bifida. However, further investigations into serial casting, as well as investigations into the use of serial casting with other interventions, are warranted.
College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
S
S
Al-Oraibi
Hashem Abu
HA
Tariah
Abdullah
A
Alanazi
D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000209:etiology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D016135:Spinal Dysraphism / Q000150:complications; D016896:Treatment Outcome
Serial casting; children with spina bifida; passive stretching; rehabilitation