Serial casting and
braces are two treatment options for reducing spasticity and
stretching contracted muscles. Casting and braces can be used
alone as a treatment method or in conjunction with other
methods. For example, after children receive medication to
reduce spasticity, they have less muscle tone and a cast may be
necessary to stretch to help prevent contracture.
Static bracing
Static
(does not move)
bracing provides a solid stretch for a length of time. Serial
casting often is used to progressively bring a foot up and
stretch the calf muscle to obtain an improved position. With
serial casting, a cast can be replaced weekly or bi-weekly to
stretch the muscle in small increments.
Braces
often are used after a child has finished with serial casting
because they are helpful in maintaining the progress achieved.
Not wearing the appropriate brace may slow or halt progress
being made. The goal of casting and braces is to support,
maintain range of motion and allow the child as much mobility as
possible.
Dynamic bracing
Children with spasticity may tend to land on their toe to
forefoot when walking, or walk with their foot rotated in or
out. Dynamic (flexible) braces can improve function during
walking by:
Braces
can also minimize tripping by helping children to swing their
feet forward rather than dragging them on the floor or catching
them on their legs.
Different needs
Each
child responds differently to various treatment methods. Because
casting and bracing are temporary, they can be tried as
alternatives to reducing spasticity.
Children and parents need to be informed about exactly how to
place the brace on the limb, how long it is to be worn and how
to watch for and prevent skiing problems that may occur.
Credit
for this article goes to Darius Picking, C.O. and Kathy Molina
and Exceptional Parent Magazine
