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Prevalence of valgus and varus foot deformities in 2784 children with cerebral palsy, a register-based cross-sectional study

Manousaki, Evgenia LU ; Rodby-Bousquet, Elisabet LU orcid ; Pettersson, Katina LU ; Hedberg-Graff, Jenny and Cloodt, Erika LU (2024) In BMC Musculoskeletal Disorders 25(1).
Abstract

Background: Foot deformities, such as valgus and varus in the coronal plane and equinus in the sagittal plane, are common in children with cerebral palsy (CP). The purpose of this study was to describe the prevalence of coronal plane foot deformities and their association with the Gross Motor Function Classification System (GMFCS) level, age, CP subtype, and equinus in children with CP. Methods: A cross-sectional study was performed of 2784 children (1644 boys, 1140 girls), mean age 10 years, 2 months (standard deviation, 4.83), from the Swedish CP Follow-up Program and registry for 2021–2023. Single and multiple binary regression analyses estimated the association between coronal plane foot deformities (valgus or varus) and sex, age,... (More)

Background: Foot deformities, such as valgus and varus in the coronal plane and equinus in the sagittal plane, are common in children with cerebral palsy (CP). The purpose of this study was to describe the prevalence of coronal plane foot deformities and their association with the Gross Motor Function Classification System (GMFCS) level, age, CP subtype, and equinus in children with CP. Methods: A cross-sectional study was performed of 2784 children (1644 boys, 1140 girls), mean age 10 years, 2 months (standard deviation, 4.83), from the Swedish CP Follow-up Program and registry for 2021–2023. Single and multiple binary regression analyses estimated the association between coronal plane foot deformities (valgus or varus) and sex, age, GMFCS level, CP subtype, and equinus. Results: More than half (58%) the children with CP had valgus feet and 6% had varus feet. Valgus feet were more common in young children with high GMFCS levels, whereas the number of varus feet remained consistently low across all GMFCS levels. The prevalence of valgus feet was lower in older children at GMFCS I and II, but remained high in older children at GMFCS III–V. Coronal plane foot deformities were associated with higher GMFCS levels (odds ratio [OR] 11, 95% confidence interval [CI] 8–15 for GMFCS V), lower age (OR 1.5, 95% CI 1.3–1.7), and equinus (OR 1.9, 95% CI 1.4–2.5). Conclusions: Most children with CP have a coronal plane foot deformity. Valgus is most commonly associated with higher GMFCS levels and lower age. These findings contribute to a mapping of the children with an increased risk of foot deformities and also highlight the need for continuous follow-up of foot deformities in children with CP.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral palsy, Equinus, Foot deformities, Valgus, Varus
in
BMC Musculoskeletal Disorders
volume
25
issue
1
article number
930
publisher
BioMed Central (BMC)
external identifiers
  • pmid:39563276
  • scopus:85209668672
ISSN
1471-2474
DOI
10.1186/s12891-024-08029-1
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2024.
id
dfe7877d-832f-474a-b9ab-b58fb83a239c
date added to LUP
2025-01-09 11:27:22
date last changed
2025-12-12 17:17:54
@article{dfe7877d-832f-474a-b9ab-b58fb83a239c,
  abstract     = {{<p>Background: Foot deformities, such as valgus and varus in the coronal plane and equinus in the sagittal plane, are common in children with cerebral palsy (CP). The purpose of this study was to describe the prevalence of coronal plane foot deformities and their association with the Gross Motor Function Classification System (GMFCS) level, age, CP subtype, and equinus in children with CP. Methods: A cross-sectional study was performed of 2784 children (1644 boys, 1140 girls), mean age 10 years, 2 months (standard deviation, 4.83), from the Swedish CP Follow-up Program and registry for 2021–2023. Single and multiple binary regression analyses estimated the association between coronal plane foot deformities (valgus or varus) and sex, age, GMFCS level, CP subtype, and equinus. Results: More than half (58%) the children with CP had valgus feet and 6% had varus feet. Valgus feet were more common in young children with high GMFCS levels, whereas the number of varus feet remained consistently low across all GMFCS levels. The prevalence of valgus feet was lower in older children at GMFCS I and II, but remained high in older children at GMFCS III–V. Coronal plane foot deformities were associated with higher GMFCS levels (odds ratio [OR] 11, 95% confidence interval [CI] 8–15 for GMFCS V), lower age (OR 1.5, 95% CI 1.3–1.7), and equinus (OR 1.9, 95% CI 1.4–2.5). Conclusions: Most children with CP have a coronal plane foot deformity. Valgus is most commonly associated with higher GMFCS levels and lower age. These findings contribute to a mapping of the children with an increased risk of foot deformities and also highlight the need for continuous follow-up of foot deformities in children with CP.</p>}},
  author       = {{Manousaki, Evgenia and Rodby-Bousquet, Elisabet and Pettersson, Katina and Hedberg-Graff, Jenny and Cloodt, Erika}},
  issn         = {{1471-2474}},
  keywords     = {{Cerebral palsy; Equinus; Foot deformities; Valgus; Varus}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Musculoskeletal Disorders}},
  title        = {{Prevalence of valgus and varus foot deformities in 2784 children with cerebral palsy, a register-based cross-sectional study}},
  url          = {{http://dx.doi.org/10.1186/s12891-024-08029-1}},
  doi          = {{10.1186/s12891-024-08029-1}},
  volume       = {{25}},
  year         = {{2024}},
}