Short Term Results of Intensive Physiotherapy in Clubfoot Deformity Treated with Ponseti Method.

This study aimed to determine the efficacy of the physical therapy program as an adjunct to the Ponseti technique in the treatment of idiopathic clubfoot. This study with the presumption of a difference in results between the study group who were included in the physiotherapy program and the control group who performed home exercises. Forty affected feet of 29 patients were included in the study. Average age of the control and study groups were15.00 ± 21.33 and 20.30 ± 15.78 months respectively. Passive range of motion of dorsiflexion, plantar flexion, inversion, eversion, rear foot varus angle and forefoot adduction angle were measured and the Dimeglio classification system was utilized in order to determine the severity of clubfoot deformity. Reassessments were carried out for the study group at the end of 1 month’s therapy and for the control group during the 1st month follow-up. Comparison of pre and post treatment assessment results revealed a difference in terms of recovery, concerning all parameters except passive inversion values in the study group and for all parameters in the control group (p < 0.05). For study and control group comparisons, since deformity severity was higher in the study group an effect size analysis was carried out. The effect size analysis showed that the change in range of motion of dorsiflexion and Dimeglio and decrease of rear foot varus angle was higher in the study group.

The results of this study imply that an intensive physiotherapy program may enhance the effectiveness of the Ponseti protocol.

Nilglan B, Suat E, Engin SI, Fatma U, Yakut Y. Short Term Results of Intensive Physiotherapy in Clubfoot Deformity Treated with Ponseti Method. Pediatr Int. 2010 Sep 11; online article ahead of press

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