The Effectiveness of serial casting versus physiotherapy therapeutic exercises in the management of knee fixed flexion contractures in children with spina bifida


Saleh AL Oraibe



General Purpose: The general purpose of this proposed study is to reduce the knee flexion contractures and help children with spina bifida to reach functional independency by using cost effective and safe intervention.

Main Purpose:

To compare physiotherapy stretching exercises with serial casting in the management of spina bifida children with fixed flexion contractures.

The main objectives of this proposed study are:

        To correct and prevent a further development of a fixed knee deformity.

        To help children with spina bifida to live productive life.

        To describe the structure, process and outcomes of using serial casting method in the management of knee flexion contractures.

        To improve the quality of life for children with spina bifida



Activities needed to arrive at above results.

Place of the study:

The study will held at Al-Hussein Society for Habilitation/Rehabilitation of the Physically Challenged (AHS), one of the largest centers for the physically challenged in Jordan.  It is a non-profit voluntary organization that provides educational, vocational, medical, and rehabilitative services to 180 physically challenged children, from birth to the age of twelve years, the majority of them are children with spina bifida


Assessment procedures:

The outcome measure to be used in this proposed study include: IMGS criteria, X-Ray ,range of movement ,Photograph and parent satisfaction.

 Assessment will be carried out with each children before treatment commences, at 4 weeks, at 2 months , and 4 months and a final assessment at 1 year.  The assessments are to be carried out by the researchers, who will remain blind to the children treatment condition.


Project Phases and Time expected to finish project.

It is anticipated that the proposed study will take up to 26 months

It is proposed to achieve the aim of the study in three stages:

Stage one:  4 months

Purchase tools needed for serial casting.

Purchase the materials needed for serial casting procedures.

Staff training (2 senior physiotherapists) on the use of serial casting and passive stretching protocol.

Stage two: 18 months

Identify children with spina bifida who meet the admission criteria.

Recruitment, assessment an treatment starts (All children should be randomized to either group within the first 6 months of this stage).

Stage three: 4 months

Data analysis and writing up the project report



      * Faculty: Allied Health Sciences / Physical Therapy .

         Specific Specialization Neurology .