Sport Ability during Walking Age in Clubfoot-Affected Children after Ponseti Method: A Case-Series Study

Pavone, Vito; Vescio, Andrea; Caldaci, Alessia; Culmone, Annalisa; Sapienza, Marco; Rabito, Mattia; Canavese, Federico; Testa, Gianluca

doi:10.3390/children8030181

Cited by 10 publications

(15 citation statements)

References 28 publications

(52 reference statements)

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“…However, no correlation between gender, number of casts, side of involvement, tenotomy, age of mother and walking age was found. There is a previous study shown the similar outcome [ 14 ]: male and female patients and patients with unilateral or bilateral involvement performed equally well, and no limitations in sport performance or activity could be observed.…”

Section: Discussionsupporting

confidence: 52%

Factors associated with the relapse in Ponseti treated congenital clubfoot

Hu¹,

Ke²,

Niansu³

et al. 2022

BMC Musculoskelet Disord

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Objectives We retrospectively investigated the clinical materials to seek the factors that lead to relapse after using the Ponseti method. Methods We retrospectively reviewed all children with congenital clubfoot treated with the Ponseti method in our hospital from June 2008 to June 2013. The data included the following factors: age, gender, initial Pinari score, number of casts, number of feet (unilateral or bilateral), age at the first casting, age of mother, tenotomy, walking age, and compliance with using bracing. All investigations were conducted in conformity with ethical standards. This study was approved by Guilin Peoples’ Hospital Ethics Committee. Results In this study, there were 148 cases (164 ft) in total that underwent the Ponseti method, with the follow–up period at least 5 years. Of them, 64 children presented with left side, 58 with right side, and 26 with bilateral cases. This study included 75 males and 73 females; sex did not affect the outcomes. The mean age of the first casting was 2.50 ± 2.15 months. The average initial Pirani score was 4.98 ± 1.33, and the average number of casts was 5.71 ± 2.28 times. The mean age of mothers at birth was 25.81 ± 2.38 years old. The walking age of children was at a mean of 14.83 ± 1.18 months. Forty-nine cases could not tolerate using braces, namely the rate of noncompliance in this study was 33.1%. Tenotomy was performed on 113 ft (76.4%). The average follow–up period was 7.27 ± 1.29 years (from 5 to 10 years). The rate of relapse was 21.6% (32 cases) at the end of the follow-up. The rate of relapse in the noncompliance with using bracing group was significantly higher compared to the compliance group . Conclusion The initial Pirani score, compliance with the foot abduction brace and the age at the first casting are three independent factors for relapse in clubfoot.

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Section: Discussionsupporting

confidence: 52%

Factors associated with the relapse in Ponseti treated congenital clubfoot

Hu¹,

Ke²,

Niansu³

et al. 2022

BMC Musculoskelet Disord

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“…These findings are consistent with a recent case-series study investigating clinical and functional sports ability and outcomes for children with clubfoot treated by the Ponseti method. 20 There were no activity limitations observed in the study cohort in regards to performance in sports, with good to excellent clinical outcomes recorded across assessments of various measures. 20 Having a family annual income of more than $100K was the only significant, positive predictor for total steps, total distance, distances (very active, moderately active), minutes (very active, moderately active), and lightly active step intensity.…”

Section: Discussionmentioning

confidence: 89%

“…20 There were no activity limitations observed in the study cohort in regards to performance in sports, with good to excellent clinical outcomes recorded across assessments of various measures. 20 Having a family annual income of more than $100K was the only significant, positive predictor for total steps, total distance, distances (very active, moderately active), minutes (very active, moderately active), and lightly active step intensity. In general, a higher socioeconomic status has been associated with increased access to sport clubs and having parents who emphasize the health benefits of exercise.…”

Section: Discussionmentioning

confidence: 89%

Clubfoot Activity and Recurrence Exercise Study (CARES)

El-Banna

Baskar

Segovia

et al. 2021

Journal of Pediatric Orthopaedics

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Background: Approximately half of treated clubfoot patients initially corrected with the Ponseti method experience relapse that requires additional treatment. The consequences of relapse on childhood activity levels have not been well studied. Ponseti noted lower functional ratings at 18-year follow-up in clubfoot patients who had undergone tibialis anterior tendon transfer for relapse. Methods: Clubfoot Activity and Recurrence Exercise study (CARES) is an observational, prospective cohort study that compares physical activity in 30 clubfoot patients without and with relapse. Eligible participants were 5 to 10 years old, diagnosed with idiopathic clubfoot at birth, and had not received any clubfoot treatment for at least 6 months before study. Recruitment for this study occurred in-person and through Facebook clubfoot groups. Consented participants wore Fitbits secured to their wrists for at least 14 days, and completed a demographic survey, Child Health Questionnaire (CHQ), and the clubfoot disease-specific instrument (CDSI). Participants' daily activity was monitored through Fitabase. Results: Participants without and with clubfoot relapse had similar daily step counts, distance walked, and step intensities, except for moderately active step intensity, which was higher in the clubfoot relapse group. Total steps, total distance, distances (very active, moderately active), minutes (very active, fairly active), and lightly active intensity of steps were significantly higher for participants whose families earn more than $100,000 per year. Various physical activities and sports were reported by both groups in daily activity sheets. Neither demographics nor the CDSI or the CHQ scores significantly differed between the 2 groups.Step counts of children with clubfoot with or without relapse were similar to published levels for healthy children. Conclusion:Children with clubfoot initially treated with the Ponseti method who undergo treatment for relapse have comparable physical activity to those who have not relapsed. They also have comparable step counts to that of the general pediatric population. These reassuring findings can guide conversations with parents when addressing concerns regarding their children's physical activity after treatment for relapse of clubfoot deformity.Level of Evidence: Level II-therapeutic studies-investigating the results of treatment.

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“…The Pirani score before the first cast (age usually < 1 week) is known to predict the amount of initial cast needed, but other authors have stated that it cannot be used to predict a future need for additional surgery [ 4 , 6 , 23 ]. In our study, the Pirani score taken just before the first cast was not predictive of future surgery.…”

Section: Discussionmentioning

confidence: 99%

The Predictive Value of Radiographs and the Pirani Score for Later Additional Surgery in Ponseti-Treated Idiopathic Clubfeet, an Observational Cohort Study

et al. 2022

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There are few validated predictors of the need for additional surgery in idiopathic clubfeet treated according to the Ponseti method. Our aim was to examine if physical examination (Pirani score) and radiographs at the age of three months (after initial correction of the clubfeet) can predict the future need for additional surgery. In this retrospective cohort study, radiographs of idiopathic clubfeet were made at the age of three months. The Pirani score was determined at the first cast, before tenotomy, and at the age of three months. Follow-up was at least five years. The correlation between the radiograph, Pirani score, and the need for additional surgery was explored with logistic regression analysis. Parent satisfaction was measured with a disease-specific instrument. The study included 72 clubfeet (50 children) treated according to the Ponseti method. Additional surgery was needed on 27 feet (38%). A larger lateral tibiocalcaneal angle (i.e., equinus) and a smaller lateral talocalcaneal angle (i.e., hindfoot varus) at the age of three months were correlated with the need for additional surgery. Higher Pirani scores before tenotomy and at the age of three months also correlated with additional surgery. Parent satisfaction was lower in patients who needed additional surgery. Both the Pirani scores and the lateral radiographs are predictive for future additional surgery.

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Sport Ability during Walking Age in Clubfoot-Affected Children after Ponseti Method: A Case-Series Study

Cited by 10 publications

References 28 publications

Factors associated with the relapse in Ponseti treated congenital clubfoot

Factors associated with the relapse in Ponseti treated congenital clubfoot

Clubfoot Activity and Recurrence Exercise Study (CARES)

The Predictive Value of Radiographs and the Pirani Score for Later Additional Surgery in Ponseti-Treated Idiopathic Clubfeet, an Observational Cohort Study

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