The Effects of Serial Casting on Spasticity: A Literature Review

Preissner, Kathy Saracco

doi:10.1080/j003v14n02_07

Cited by 12 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The stretching exercises can cause discomfort to the children, they are time consuming for the patient their families (Hadden and Von Baeyer, 2002) and the physiotherapists (Wiart et al, 2008). Additionally, there is limited evidence to support functional improvements, e.g., in gait and mobility, after stretching interventions (Preissner, 2002;Katalinic et al, 2011;Harvey et al, 2017). Clearly a significant gap exists between the clinical rationale for implementing stretching and the supporting evidence for its intended effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Stretching Interventions in Children With Cerebral Palsy: Why Are They Ineffective in Improving Muscle Function and How Can We Better Their Outcome?

et al. 2020

View full text Add to dashboard Cite

Hyper-resistance at the joint is one of the most common symptoms in children with cerebral palsy (CP). Alterations to the structure and mechanical properties of the musculoskeletal system, such as a decreased muscle length and an increased joint stiffness are typically managed conservatively, by means of physiotherapy involving stretching exercises. However, the effectiveness of stretching-based interventions for improving function is poor. This may be due to the behavior of a spastic muscle during stretch, which is poorly understood. The main aim of this paper is to provide a mechanistic explanation as to why the effectiveness of stretching is limited in children with CP and consider clinically relevant means by which this shortcoming can be tackled. To do this, we review the current literature regarding muscle and tendon plasticity in response to stretching in children with CP. First, we discuss how muscle and tendon interact based on their morphology and mechanical properties to provide a certain range of motion at the joint. We then consider the effect of traditional stretching exercises on these muscle and tendon properties. Finally, we examine possible strategies to increase the effectiveness of stretching therapies and we highlight areas of further research that have the potential to improve the outcome of non-invasive interventions in children with cerebral palsy.

show abstract

Section: Introductionmentioning

confidence: 99%

Stretching Interventions in Children With Cerebral Palsy: Why Are They Ineffective in Improving Muscle Function and How Can We Better Their Outcome?

et al. 2020

View full text Add to dashboard Cite

show abstract

“…One strategy is to combine BoNT injection with therapeutic physical modalities [46]. Physical modalities have been shown to be effective in reducing hypertonia and increasing range of motion, such as splinting and casting [47][48][49][50][51]. However, a systematic review on the use of upper extremity casting found high variability in casting protocols which indicates no consensus in technique [52].…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Assessment of the Time Course of Biomechanical, Electrophysiological and Neuro-Motor Effects after Botulinum Toxin Injections in Elbow Flexors of Chronic Stroke Survivors with Spastic Hemiplegia: A Cross Sectional Observation Study

Chen

Liu

Zhang

et al. 2022

Toxins

View full text Add to dashboard Cite

Botulinum neurotoxin (BoNT) is commonly used to manage focal spasticity in stroke survivors. This study aimed to a perform comprehensive assessment of the effects of BoNT injection. Twelve stroke subjects with spastic hemiplegia (age: 52.0 ± 10.1 year; 5 females) received 100 units of BoNT to the spastic biceps brachii muscles. Clinical, biomechanical, electrophysiological, and neuro-motor assessments were performed one week (wk) before (pre-injection), 3 weeks (wks) after, and 3 months (mons) after BoNT injection. BoNT injection significantly reduced spasticity, muscle strength, reflex torque, and compound muscle action potential (CMAP) amplitude of spastic elbow flexors (all p < 0.05) during the 3-wks visit, and these values return to the pre-injection level during the 3-mons visit. Furthermore, the degree of reflex torque change was negatively correlated to the amount of non-reflex component of elbow flexor resistance torque. However, voluntary force control and non-reflex resistance torque remained unchanged throughout. Our results revealed parallel changes in clinical, neurophysiological and biomechanical assessment after BoNT injection; BoNT injection would be more effective if hypertonia was mainly mediated by underlying neural mechanisms. BoNT did not affect voluntary force control of spastic muscles.

show abstract

“…Casting, defined as a nonremovable external device, provides total contact pressure that provides prolonged muscle-tendon stretch for contracture prevention and may reduce the afferent sensory input from cutaneous, muscle, and joint receptors that contribute to spasticity. Casting may also contribute to a decreased alpha motor excitability which may also improve spasticity 9 …”

mentioning

confidence: 99%

“…Casting may also contribute to a decreased alpha motor excitability which may also improve spasticity. 9 A large observational study found that BoNT has a clinically significant effect on elbow flexor spasticity, a common pattern seen in poststroke patients. 10 Furthermore, a prospective study and a recent systematic review support that BoNT injection of the spastic upper limb muscles improves gait, which may be augmented by casting.…”

mentioning

confidence: 99%

Upper Limb Casting Application Post-Botulinum Toxin Injection for Elbow Spasticity: A Guided Casting Protocol

WORTLEY,

CARDA,

GANZERT

et al. 2024

Am J Phys Med Rehabil

View full text Add to dashboard Cite

Casting is an effective adjunctive treatment which increases the effects of botulinum toxin on patients with spasticity. The evidence for casting as an adjunctive therapy post-botulinum toxin has been well documented in the literature. However, standardized casting protocols are lacking, with no published descriptions of upper limb casting application post-botulinum toxin injection for spasticity. In this paper we will describe our experience regarding the application of upper limb casting as an adjunctive therapy for elbow spasticity, detailing indications, contraindications and description of our protocol (materials required and technique).

show abstract

The Effects of Serial Casting on Spasticity: A Literature Review

Cited by 12 publications

References 15 publications

Stretching Interventions in Children With Cerebral Palsy: Why Are They Ineffective in Improving Muscle Function and How Can We Better Their Outcome?

Stretching Interventions in Children With Cerebral Palsy: Why Are They Ineffective in Improving Muscle Function and How Can We Better Their Outcome?

Comprehensive Assessment of the Time Course of Biomechanical, Electrophysiological and Neuro-Motor Effects after Botulinum Toxin Injections in Elbow Flexors of Chronic Stroke Survivors with Spastic Hemiplegia: A Cross Sectional Observation Study

Upper Limb Casting Application Post-Botulinum Toxin Injection for Elbow Spasticity: A Guided Casting Protocol

Contact Info

Product

Resources

About