What intervention would most likely reduce contractures in a child with cerebral palsy?

• A. Aggressive static stretching without casting
• B. Complete bed rest
• C. Serial casting to gradually lengthen tight muscles
• D. Immediate surgery

Answer: (C)

Managing contractures in cerebral palsy hinges on gradually lengthening tight muscle-tendon units to increase and maintain range of motion. Serial casting does this by applying a sequence of casts that progressively stretch the muscle over weeks, allowing tissue remodeling without forcing a large, sudden stretch. This approach often improves ankle, knee, or hip ROM and helps align joints, supporting gait and function when paired with targeted physical therapy.

Aggressive static stretching without casting provides a stretch but not a sustained, progressive lengthening, so gains are less durable. Complete bed rest is inappropriate and risks disuse atrophy and additional complications. Immediate surgery is invasive and reserved for fixed deformities or when nonoperative methods fail. Therefore, serial casting is the intervention most likely to reduce contractures in this setting.