Short-term results of intensive physiotherapy in clubfoot deformity treated with the Ponseti method

Abstract

Purpose: We 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 was carried out 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. Patients and method: Forty affected feet of 29 patients were included in the study. The average ages of the control and study groups were 15.00 ± 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 first month follow-up. Results: 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. Conclusion: The results of this study imply that an intensive physiotherapy program may enhance the effectiveness of the Ponseti protocol. © 2011 Japan Pediatric Society.