Physical Therapy & Rehabilitation Science
DPT (Doctor of Physical Therapy)
Session and Year of Graduation
Laura Frey Law
Background: Ankle plantarflexion contractures are common among children with spastic cerebral palsy, resulting in a toe-walking gait pattern. While surgery for heel cord lengthening is common, many parents look towards a more conservative treatment method. The purpose of this case report is to highlight the successful use of serial casting for the treatment of an ankle plantarflexion contracture. Case Description: The patient was an 11-year-old female with spastic hemiplegic Cerebral Palsy and a right plantarflexion contracture. She could no longer wear her custom-fit ankle foot orthosis (AFO) and ambulated with a toe walking pattern on her right side. She previously was treated by physical therapy for aggressive manual stretching. Intervention: Four weeks of serial casting by a physical therapist was used in an attempt to reduce her ankle contracture and allow for a new AFO fitting. The serial casts allowed for weight bearing throughout daily activities. Outcomes: The patient gained 16° of passive dorsiflexion range of motion (PROM), and 9° of active range of motion (AROM). After casting, the patient was able to be fitted for a custom AFO and demonstrated heel strike more consistently in her gait pattern. While the patient demonstrated minimal muscle atrophy on her R ankle, she was given a home exercise program for strengthening following the intervention. Discussion: This case report describes the utilization of serial casting as a conservative treatment approach for heel cord lengthening with minimal complications, such as skin irritation. These results suggest that serial casting may be an option to help regain ankle range of motion and improved gait performance in children with cerebral palsy.
Copyright © 2017 Katrina Mahoney