† § and on behalf of the Dutch Clubfoot CentresBackground: Functioning in children consists of different aspects, including their ability to execute activities and participate in life situations. Several studies on children with clubfeet showed limited motor abilities and walking capacity compared with healthy control children, while other studies showed comparable athletic abilities and gross motor development. Although participation in activities of daily life plays an important role in the development of children, this has not yet been investigated in children with clubfeet. The study aims to determine the level of parents' perceived motor ability and participation in Ponsetitreated children with clubfeet compared with age-matched healthy controls. Methods: Parents of children aged 5 to 9 years with and without idiopathic Ponseti-treated clubfeet were asked to complete an online questionnaire about their child's motor abilities and participation level using the Dutch version of the Assessment of Life Habits for Children (LIFE-H) version 3 to assess participation and the Dutch Movement Assessment Battery for Children-2 Checklist (MABC-2 Checklist) to assess motor abilities. Statistical analysis focused on differences between groups and the relationship between motor abilities and level of participation.Results: Questionnaires of 86 children with clubfeet (mean age 7.1, 73% boys) and 62 controls (age 6.7, 53% boys) were analyzed. Despite a large variation, results showed no significant differences between groups on the total scores of the LIFE-H and the MABC-2 Checklist. Children with clubfeet, however, scored lower on Mobility and better on the categories Communication and Responsibility of the LIFE-H. Furthermore, children with clubfeet showed lower scores on the MABC-2 Checklist subscale "movement in a static and/or predictable environment." High levels of the parents' perceived participation correlate with good results, as perceived by the parents, in motor ability. Conclusions: Although differences on some aspects of motor ability and participation existed, children with clubfeet in general showed high levels of parents' perceived motor ability and participation. High levels of participation correlated with good results in motor ability. Level of Evidence: Level II.
BACKGROUND: A relatively high number of users is dissatisfied with their orthopaedic device. The term ‘user practice’ was introduced to emphasise the idea that users of orthopaedic devices perform activities within an environment, which are characteristic for that environment. OBJECTIVE: To investigate to what extend orthopaedic shoe engineers map the specific environments in which users live and the activities they perform within these environments during the first intake for custom made orthopaedic footwear. METHODS: Orthopaedic shoe engineers were recruited from orthopaedic service providers across The Netherlands. The intake with a new client for orthopaedic footwear was recorded and analysed using four user environments: daily life at home, transport, work, and leisure. RESULTS: Our study showed that orthopaedic shoe engineers cover at best less than 50% of activities within the four user environments. Consequently, there is no guarantee that the resulting design of the orthopaedic footwear fits all of the activities and environments of the users. CONCLUSIONS: The principles of user practices, consisting of specific environments and activities of the user, are not yet adequately used in the field of orthopaedic shoe engineering. By not using them, too little understanding of the life of the user can result in dissatisfaction and non-usage of the orthopaedic device.
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