Affiliations: College of Applied Medical Sciences, King Saud Bin
Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia | Department of Occupational Therapy, Faculty of Allied
Health Sciences, The Hashemite University, Zarqa, Jordan
Note: [] Corresponding author: Saleh Al-Oraibi, College of Applied
Medical Sciences/King Saud Bin Abdul-Aziz University for Health
Sciences/National Guard, Health Affairs, P.O. Box 2490 Riyadh 11426. Mail Code:
3129/Saudi Arabia and Hashemite University, Jordan. E-mail:
oraibis@Ksau-Hs.edu.sa, Aloraibisa@ngha.med.sa
Abstract: 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. PURPOSE: 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. CONCLUSION: 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.
Keywords: Serial casting, children with spina bifida, passive stretching, rehabilitation
