There is no definitive evidence showing that serial casting does or does not improve ankle passive ROM and functional mobility in the head-injured adult. Five of the eight reviewed articles indicate an improvement in passive ankle dorsiflexion ROM, suggesting a potential benefit for the appropriate patient. However, all eight articles had significant threats to internal and external validity such as small sample size, no control group, and lack of adequate follow-up. These threats limit the applicability of the results. Further research is necessary, specifically focusing on functional mobility and long-term effects. Based on these results, it is recommended that clinical judgment be a key factor in determining the appropriateness of serial casting per patient presentation in the head-injured population.
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