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Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method
PURPOSE: A mild delay in gross motor milestones and walking age has been reported in infants with clubfoot. The influence of different treatments on motor development has been poorly investigated. Some parents and physical therapists express concern that the Ponseti method (PM) and its constraints (...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808080/ https://www.ncbi.nlm.nih.gov/pubmed/31695814 http://dx.doi.org/10.1302/1863-2548.13.190097 |
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author | Zanardi, A. Fortini, V. Abati, C. N. Bettuzzi, C. Salvatori, G. Prato, E. Di Giacinto, S. Lampasi, M. |
author_facet | Zanardi, A. Fortini, V. Abati, C. N. Bettuzzi, C. Salvatori, G. Prato, E. Di Giacinto, S. Lampasi, M. |
author_sort | Zanardi, A. |
collection | PubMed |
description | PURPOSE: A mild delay in gross motor milestones and walking age has been reported in infants with clubfoot. The influence of different treatments on motor development has been poorly investigated. Some parents and physical therapists express concern that the Ponseti method (PM) and its constraints (abduction brace, casts) would affect development more than the French physical therapy method (FM) due to greater immobilization and lesser stimulation. The purpose of this study was to evaluate achievement of three motor milestones (pull-to-standing, cruising and independent walking) in two groups of clubfoot patients treated at two experienced institutes respectively with the PM and FM. METHODS: In all, 52 consecutive infants (full-term at birth, mean age at beginning of treatment 24.3 days (sd 10), mean Dimeglio score 12 (sd 3.4)) were prospectively enrolled (26 patients per centre) and followed up to walking age recording milestones. RESULTS: The two groups were not different in terms of age at the beginning of treatment (p = 0.067) and rate of tenotomy. Age at tenotomy was significantly lower in the PM group (p = 0.000). Severity (p = 0.004) and number of bilateral cases (p = 0.012) were higher in the PM group. A non-significant difference was found for age of achievement of pull-to-standing (p = 0.109), cruising (p = 0.253) and independent ambulation (p = 0.349) between the two groups. Overall, milestones were achieved approximately two months later than normal population. Sex, severity, laterality and need of tenotomy were not found to significantly influence milestones. CONCLUSION: Our results confirmed that infants with clubfoot are expected to have a minimum delay in motor development. Infants treated with the PM and those treated with the FM did not show significant differences in gross motor milestones achievement at walking age. LEVEL OF EVIDENCE: Level II – Prospective comparative therapeutic studies |
format | Online Article Text |
id | pubmed-6808080 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-68080802019-11-06 Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method Zanardi, A. Fortini, V. Abati, C. N. Bettuzzi, C. Salvatori, G. Prato, E. Di Giacinto, S. Lampasi, M. J Child Orthop Original Clinical Article PURPOSE: A mild delay in gross motor milestones and walking age has been reported in infants with clubfoot. The influence of different treatments on motor development has been poorly investigated. Some parents and physical therapists express concern that the Ponseti method (PM) and its constraints (abduction brace, casts) would affect development more than the French physical therapy method (FM) due to greater immobilization and lesser stimulation. The purpose of this study was to evaluate achievement of three motor milestones (pull-to-standing, cruising and independent walking) in two groups of clubfoot patients treated at two experienced institutes respectively with the PM and FM. METHODS: In all, 52 consecutive infants (full-term at birth, mean age at beginning of treatment 24.3 days (sd 10), mean Dimeglio score 12 (sd 3.4)) were prospectively enrolled (26 patients per centre) and followed up to walking age recording milestones. RESULTS: The two groups were not different in terms of age at the beginning of treatment (p = 0.067) and rate of tenotomy. Age at tenotomy was significantly lower in the PM group (p = 0.000). Severity (p = 0.004) and number of bilateral cases (p = 0.012) were higher in the PM group. A non-significant difference was found for age of achievement of pull-to-standing (p = 0.109), cruising (p = 0.253) and independent ambulation (p = 0.349) between the two groups. Overall, milestones were achieved approximately two months later than normal population. Sex, severity, laterality and need of tenotomy were not found to significantly influence milestones. CONCLUSION: Our results confirmed that infants with clubfoot are expected to have a minimum delay in motor development. Infants treated with the PM and those treated with the FM did not show significant differences in gross motor milestones achievement at walking age. LEVEL OF EVIDENCE: Level II – Prospective comparative therapeutic studies The British Editorial Society of Bone & Joint Surgery 2019-10-01 /pmc/articles/PMC6808080/ /pubmed/31695814 http://dx.doi.org/10.1302/1863-2548.13.190097 Text en Copyright © 2019, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
spellingShingle | Original Clinical Article Zanardi, A. Fortini, V. Abati, C. N. Bettuzzi, C. Salvatori, G. Prato, E. Di Giacinto, S. Lampasi, M. Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method |
title | Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method |
title_full | Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method |
title_fullStr | Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method |
title_full_unstemmed | Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method |
title_short | Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method |
title_sort | standing and walking age in children with idiopathic clubfoot: french physiotherapy versus ponseti method |
topic | Original Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808080/ https://www.ncbi.nlm.nih.gov/pubmed/31695814 http://dx.doi.org/10.1302/1863-2548.13.190097 |
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