Serial Casting and Dynamic Flex Casting are proven, non-invasive methods in physical therapy for gently stretching shortened muscles, correcting foot alignment, and specifically improving joint mobility. Special plaster casts are applied over several weeks to hold the affected limb in a stretched or anatomically corrected position. The goal is to gradually increase muscle and tendon length, correct misalignments, and thus sustainably promote functionality, stability, and range of motion.
At the beginning of every casting treatment—whether Serial Casting or Dynamic Flex Casting—our specialized team assesses the mobility and function of the affected limb. Based on this, we will jointly decide which method is best suited for your child.
Serial Casting
Here, the joint is positioned to allow gentle stretching of the shortened muscle. The cast remains in place for five to ten days, then is removed and replaced with a new one with a slightly increased stretch. This is repeated over three to six weeks, usually in four sessions. The goal is a gradual improvement in mobility through lengthening of the muscle and tendon structures.
Dynamic Flex Casting
Dynamic Flex Casting focuses on actively improving the functional movement pattern. A semi-rigid, lightweight cast allows the child to continue standing, walking, and engaging in targeted exercises. It is used for two to three weeks, particularly in cases of gait abnormalities or muscular imbalances.
A special quality feature of ours: The plaster cast is provided in close cooperation with experienced orthopedic technicians to ensure optimal foot alignment and maximum effect.
What's the point?
✅ Improved mobility: Both serial casting and dynamic flex casting help improve joint mobility – either through passive stretching (serial casting) or through active exercise in a functional position (dynamic flex casting).
✅ Reduced muscle tension and improved muscle activity: Serial casting can reduce tension in spastic muscles, while dynamic flex casting specifically promotes the activity of foot lifters and flexors.
✅ Avoiding surgery: Through gradual correction and mobilization, surgical interventions can be avoided or significantly delayed in many cases.
✅ Improved functionality in everyday life: Both methods improve the ability to perform activities such as standing, walking, or grasping – depending on the affected area. Dynamic Flex Casting, in particular, allows children to continue standing, walking, and practicing movement patterns during treatment.
✅ Complement to other therapies: Serial Casting and Dynamic Flex Casting can be ideally combined with other measures such as botulinum toxin injections, orthotic treatment or intensive physiotherapy sessions.
Overall, both methods are effective and gentle approaches to specifically promote your child's mobility, posture, and motor control. They offer a structured path to greater independence, mobility, and quality of life – entirely without surgery, but with sustainable progress, embedded in a comprehensive Sensophysio therapy concept.
The costs for a Serial or Dynamic Flex cast treatment depend on the individual treatment course and the affected extremity. A rough guideline is:
👉 350 to 550 CHF per extremity and session
This price includes:
the individual preparation and recording of findings,
the material costs (including high-quality dressings and padding),
as well as the plaster application by our experienced team including orthopaedic technicians.
Typically, a complete cycle includes four appointments:
✅ First appointment with diagnosis and application of the first plaster cast
✅ Second appointment with the first plaster change
✅ Third appointment with another cast change
✅ Final appointment with removal of the last plaster
Prices are guidelines only and may vary slightly depending on the effort involved, treatment goals, and individual situation. We believe in transparent pricing – you will receive a clear estimate of the expected costs before treatment begins. We are happy to answer any questions you may have.
Dynamic Flex Casting is primarily aimed at children with gait abnormalities or muscular imbalances who do not have fixed contractures or structural deformities. This method is primarily used as part of intensive pediatric physical therapy when the goal is to improve functional movement patterns and specifically promote muscular activity without restricting mobility.
This method is particularly suitable for children with:
✅ Tiptoe walking
✅ Easy crouching
✅ Mild muscular imbalance
✅ Neurological abnormalities without severe structural limitations
✅ Disturbances in balance or postural control
✅ Need for additional functional stimulus to improve gait
Dynamic Flex Casting is ideal for children who need to remain active while also requiring better foot alignment and targeted muscle activation. Especially during intensive therapy phases – typically lasting 2 to 3 weeks – Dynamic Flex Casting can be an effective, movement-friendly alternative or complement to rigid orthoses.
At ApexaQLA, we place great importance on optimally correcting foot alignment. Therefore, we work closely with experienced orthopedic technicians for Dynamic Flex Casting. This ensures that, in addition to the therapeutic effect, correct anatomical alignment is also professionally maintained – for maximum effectiveness and safety in everyday life. Dynamic Flex Casting is part of our holistic Sensophysio concept , which combines targeted sensory stimuli with active movement to achieve sustainable progress in movement behavior.
Serial Casting is suitable for children, adolescents, and adults who have limited mobility due to muscle shortening, spasticity, or neurological disorders. This method can provide targeted support, especially when conventional stretching exercises alone are insufficient.
This method is particularly suitable for people with:
✅Cerebral palsy
✅Spina bifida
✅Brain injuries
✅Spinal cord injuries
✅Muscular dystrophy
✅Idiopathic tiptoe walking
✅Arthrogryposis
✅Peripheral neuropathy
✅Brachial plexus paralysis
Both children and adults can benefit from serial casting, especially if they suffer from muscle shortening or limited mobility.
Whether to support walking, improve arm or foot function, or as a complement to other therapies, serial casting helps you regain freedom of movement and perform everyday activities more easily. The cast is applied directly in our center by an experienced technician and seamlessly integrated into your treatment plan. We often combine serial casting with our intensive therapy concepts centered around Sensophysio to specifically support treatment success.
After completing a Serial Casting or Dynamic Flex Casting cycle, a crucial phase begins: stabilizing the progress achieved. The goal is to maintain the newly gained mobility, improved posture, or corrected foot position long-term and to transfer it into everyday life.
After Serial Casting
After the final cast in the series, your child will typically be fitted with AFOs (ankle-foot orthoses) to be worn during the day, as well as special night splints to stabilize the foot in an overextended position. The AFOs hold the foot at a 90-degree angle, while the night splints hold it slightly above this angle, thus maintaining the achieved extension.
How long the AFOs need to be worn depends on how well your child can maintain their new mobility through strength training and everyday activities. One of the biggest challenges is permanently abandoning the toe walk – this takes time, repetition, and a lot of patience.
After Dynamic Flex Casting
Since Dynamic Flex Casting does not involve rigid immobilization, but rather active movement is part of the concept, the focus after the cast is removed is more on continuing functional training. This involves further targeted work on posture, gait, and muscle activation – ideally integrated into a comprehensive intensive program such as Sensophysio. Orthoses can also be used temporarily, especially at night or for specific indications.
Parent training as the key to success
A central component of our family-centered approach is parent training. You'll receive targeted, practical exercises that you can use to support your child at home, including:
✅Heel taps on the wall to promote heel strike
✅Leg circles and up-and-down movements, ideally three times a day
These exercises specifically strengthen the hip flexors and thigh muscles and promote conscious body awareness. They also help your child use their newly acquired range of motion effectively and reprogram automated movement patterns.
As with braces, a retainer phase is necessary after Serial or Dynamic Flex Casting to prevent relapse. Early follow-up care, close cooperation with the treatment team, and consistent home support are crucial for long-term success.
The earlier you start and the more consistently you stick with it, the greater the chances of stable, functional improvements in everyday life.
Sensophysio is a concept specially developed by ApexaQLA Suisse that combines targeted sensory stimuli with physiotherapy methods to promote motor control, perceptual processing, and neurological development. Through multifaceted stimulation of the senses—visual, tactile, proprioceptive, and vestibular—neuronal connections are strengthened and natural movement patterns are improved. The goal is to address the central nervous system on multiple levels and enable effective, sustainable progress in movement and everyday life.
If necessary, Sensophysio is supplemented by targeted techniques such as serial casting – a proven method for gradually stretching shortened muscles using serial casting. Serial casting can be ideally integrated into our therapy concept to create the structural prerequisites for functional movement improvements. This creates an optimal combination of sensory activation and mechanical mobilization.
Our approach is based on the latest scientific findings and years of practical experience. Fabienne Theler MSc PT, a leading expert in the field of sensory physiotherapy and neurological rehabilitation, brings her extensive experience from international research and practice to her daily work. Her insights from China and the United Kingdom, as well as her master's degree from the renowned King's College London, shape the continuous development of Sensophysio – for a therapy that is individually tailored, holistic, and highly effective.
In our child-friendly therapy centre, we create a stimulating and supportive environment where children feel comfortable and can develop their potential. With individually tailored sensory stimulation and targeted movement exercises, we promote their motor skills, sensory integration, and neural networking – playfully and effectively.
Sensophysio is more than just therapy—it's a holistic development approach for a strong future. Let's take the next step together! We look forward to getting to know you!