A Longitudinal Study of Motor and Cognitive Development in Infants With Congenital Idiopathic Clubfoot

Abstract

It was the aim of this study to examine the motor and cognitive development of infants with congenital idiopathic clubfoot, compared with typically developing infants. We repeatedly tested the gross motor, fine motor, and cognitive abilities of 12 infants with clubfoot and 12 typically developing infants at the ages of 4, 6, 9, and 12 months with the Bayley-III Scales. All infants with clubfoot were treated with the Ponseti method, which led to a restriction of normal movements of the lower extremities in the first months of life. They showed a great delay in gross motor development but not in fine motor or cognitive development. However, in the clubfoot group, we found some slight deficits in specific cognitive tasks, including problem solving and spatial memory. In addition, our results revealed significant correlations between gross and fine motor performance and cognitive performance in the control group but only between fine motor and cognitive performance in infants with clubfoot, indicating that both, fine and gross motor skills, are related to cognitive processes and can mutually replace each other to a certain degree. Further research is needed to gain a deeper understanding of clubfoot infants’ development and to clarify the need for mobility training.

Motor and cognitive functioning in children treated for idiopathic clubfoot at the age of 3 years

“…Second, as expected, the present results demonstrated age-appropriate fine motor performances in 40-months old children with idiopathic clubfoot. Our findings confirmed previous findings in infants treated for idiopathic clubfoot [14, 31].…”

“…Based on previous studies [14–17], we expected that children treated for idiopathic clubfoot would be delayed in gross motor development but we did not expect to find any impact on fine motor development. According to a previous study [23], we did not expect any gross motor differences between children with unilateral and children with bilateral clubfoot.…”

“…The Ponseti method consists of weekly manipulation and casting, percutaneous Achilles tenotomy (90% of patients) and foot abduction bracing [8, 9]. Previous studies in infants treated for idiopathic clubfoot revealed some gross motor impairments, especially in the second part of the first year of life, particularly in crawling and walking [14–17]. Additionally, there seems to be some slight deficits in specific cognitive tasks, including problem solving and spatial cognition in clubfoot infants [14], that parallels the corresponding link between motor and cognitive development in healthy infants [18–21] and infants with locomotor delay due to spina bifida [22].…”

“…Previous studies in infants treated for idiopathic clubfoot revealed some gross motor impairments, especially in the second part of the first year of life, particularly in crawling and walking [14–17]. Additionally, there seems to be some slight deficits in specific cognitive tasks, including problem solving and spatial cognition in clubfoot infants [14], that parallels the corresponding link between motor and cognitive development in healthy infants [18–21] and infants with locomotor delay due to spina bifida [22]. Moreover, studies in older children treated for idiopathic clubfoot demonstrated an increased risk of motor activity limitations [23], gross motor deficits and asymmetrics [24] as well as a slightly decreased walking capacity [25].…”

Die motorische Entwicklung von Kindern mit frühkindlichem Innenschielen

“…Erst als die Säuglinge sich selbst fortbewegen konnten verbesserte sich ihre Leistung deutlich [13]. Auch Dillmann und Kollegen [14] fanden Defizite in einer visuell-räumlichen Suchaufgabe, und zwar bei Säuglingen, die an kongenitalem idiopathischem Klumpfuß erkrankt waren. Im Alter von 12 Monaten schnitten diese grobmotorisch verzögerten Säuglinge in einer visuell-räumlichen Suchaufgabe signifikant schlechter ab als gleichaltrige gesunde Säuglinge.…”