Botulinum Toxin A & Weekly Serial Casting in ABI Inpatients With Lower Extremity Spasticity

Inclusion Criteria * Patients with Acquired Brain Injury (ABI) including but not limited to stroke, traumatic and anoxic brain injury in ABI unit of RRC * Dorsiflexion limitation of \< 10 degrees from neutral and Modified Ashworth Score (MAS) of 2 or 3 * Patients that are on Oral Medication for Spasticity Tx are still allowed to participate (ie. Baclofen) * Patients both with Bilateral or Unilateral Lower Limb Spasticity are included * There will be no sex or age restrictions Exclusion Criteria * Patients cannot have had Botulinum Toxin A Injections in their Lower Extremities within the past 6 months * Patients cannot have had any sort of custom bracing or serial casting previously * Patients with MAS of 4 * Patients with generalized spasticity that require other alternative treatment such as intra-thecal baclofen or surgical intervention * Patients need to be medically stable (all co-morbidities under control via medical/pharmacological therapy), patients with ongoing co-morbid medical condition that are unmanaged will be excluded. * Patients whom have skin breakdown in their lower extremities prior to the study will be excluded * Patients who develop Skin breakdown (Grade 2 or higher) during the course of the study will be removed automatically