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Evaluation of gait, relapse and compliance in clubfoot treatment with custom-made orthoses

Manousaki, Evgenia LU ; Czuba, Tomasz; Hägglund, Gunnar LU ; Mattsson, Louise and Andriesse, Hanneke LU (2016) In Gait and Posture 50. p.8-13
Abstract

Relapse after successful initial correction of idiopathic clubfoot with the Ponseti method is often related to poor compliance with the foot abduction orthosis (FAO). The aim of this study was to evaluate treatment with custom-made dynamic orthoses. Twenty children with idiopathic clubfoot (30 feet) who had been treated with dynamic orthoses after the correction phase according to the Ponseti casting technique were evaluated. Relapse rates during orthotic treatment were registered. A Vicon gait analysis system was used to measure gait parameters at the age of seven years. The overall gait quality was estimated with the Gait Deviation Index (GDI). Data were analyzed with a nested mixed model and compared with a control group of 16... (More)

Relapse after successful initial correction of idiopathic clubfoot with the Ponseti method is often related to poor compliance with the foot abduction orthosis (FAO). The aim of this study was to evaluate treatment with custom-made dynamic orthoses. Twenty children with idiopathic clubfoot (30 feet) who had been treated with dynamic orthoses after the correction phase according to the Ponseti casting technique were evaluated. Relapse rates during orthotic treatment were registered. A Vicon gait analysis system was used to measure gait parameters at the age of seven years. The overall gait quality was estimated with the Gait Deviation Index (GDI). Data were analyzed with a nested mixed model and compared with a control group of 16 healthy children. No relapse occurred during the orthotic treatment. High compliance with the orthoses was observed based on parents’ self report and physiotherapist observations. Gait analysis showed decreased ankle power and moment, increased internal foot progression, decreased dorsiflexion during stance, and increased plantar flexion at initial contact compared with the control group. Hip and shank rotations were normal. No calcaneus or equinus gait was observed. The mean GDI was 89.7 (range 71.6–104). The gait analysis outcomes and frequency of relapse were comparable to those of previous studies. Internal foot progression originated primarily from the foot level and was not, as frequently found after FAO treatment, compensated by external rotation at knee or hip level. In children exhibiting poor compliance with an FAO, this dynamic model is considered an effective alternative.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Clubfoot, Compliance, Gait analysis, Orthosis, Relapse
in
Gait and Posture
volume
50
pages
6 pages
publisher
Elsevier
external identifiers
  • Scopus:84984693510
  • WOS:000387192600002
ISSN
0966-6362
DOI
10.1016/j.gaitpost.2016.08.005
language
English
LU publication?
yes
id
5fcb6927-5d88-43e7-977b-3419c7de8086
date added to LUP
2016-09-29 11:40:11
date last changed
2017-01-01 08:35:31
@article{5fcb6927-5d88-43e7-977b-3419c7de8086,
  abstract     = {<p>Relapse after successful initial correction of idiopathic clubfoot with the Ponseti method is often related to poor compliance with the foot abduction orthosis (FAO). The aim of this study was to evaluate treatment with custom-made dynamic orthoses. Twenty children with idiopathic clubfoot (30 feet) who had been treated with dynamic orthoses after the correction phase according to the Ponseti casting technique were evaluated. Relapse rates during orthotic treatment were registered. A Vicon gait analysis system was used to measure gait parameters at the age of seven years. The overall gait quality was estimated with the Gait Deviation Index (GDI). Data were analyzed with a nested mixed model and compared with a control group of 16 healthy children. No relapse occurred during the orthotic treatment. High compliance with the orthoses was observed based on parents’ self report and physiotherapist observations. Gait analysis showed decreased ankle power and moment, increased internal foot progression, decreased dorsiflexion during stance, and increased plantar flexion at initial contact compared with the control group. Hip and shank rotations were normal. No calcaneus or equinus gait was observed. The mean GDI was 89.7 (range 71.6–104). The gait analysis outcomes and frequency of relapse were comparable to those of previous studies. Internal foot progression originated primarily from the foot level and was not, as frequently found after FAO treatment, compensated by external rotation at knee or hip level. In children exhibiting poor compliance with an FAO, this dynamic model is considered an effective alternative.</p>},
  author       = {Manousaki, Evgenia and Czuba, Tomasz and Hägglund, Gunnar and Mattsson, Louise and Andriesse, Hanneke},
  issn         = {0966-6362},
  keyword      = {Clubfoot,Compliance,Gait analysis,Orthosis,Relapse},
  language     = {eng},
  month        = {10},
  pages        = {8--13},
  publisher    = {Elsevier},
  series       = {Gait and Posture},
  title        = {Evaluation of gait, relapse and compliance in clubfoot treatment with custom-made orthoses},
  url          = {http://dx.doi.org/10.1016/j.gaitpost.2016.08.005},
  volume       = {50},
  year         = {2016},
}