MILESTONE DEVELOPMENT IN CHILDREN WITH IDIOPATHIC CLUBFOOT TREATED BY PONSETI METHOD

M. Naseer Butt¹, W. Perveen², I. Khan³

¹Muzaffarabad Physical Rehabilitation Centre, Muzaffarabad (AJ&K), Pakistan, ²CMH Lahore Medical College & Institute of Dentistry, National University of Medical Sciences, School of Allied Health Sciences, Lahore, Pakistan, ³Muzaffarabad Physical Rehabilitation Centre, Muzaffarabad(AJ&K), Pakistan

Background: Congenital Talipes Equinovarus (Clubfoot) can be well treated by Ponseti method. Milestones development in children with idiopathic clubfoot needs attention.

Purpose: To investigate the age at which children with idiopathic clubfoot treated by Ponseti method achieved developmental milestones in comparison with their normal siblings and to find out its association with age of start of the treatment.

Methods: It was retrospective cohort study. Data was collected through self-structured questionnaire from the parents of children with clubfoot who visited the Muzaffarabad Physical Rehabilitation Centre from February 2022 to August 2022. Convenient sampling was done. Both male and female children with idiopathic clubfoot and their normal siblings who have already achieved their milestones were included in the study. Data was analyzed using SPSS-21. Pearson co-relation was applied to find the difference in mean age of milestone development among groups. Cross tabulation was carried out to find the relation of milestone development with age of start of treatment.

Results: Total 74 children participated in the study. 37 children with clubfoot (59 feet, 22 bilateral, 15 unilateral) and 37 normal siblings. The average age±SD was 4.8±1.6 years. Out of 74 children 44 (59.5%) were male and 30(40.5%) were female. The 7 milestone (neck holding, rolling over, crawling, sitting without support, standing with assistance, standing without support, walking without support) were assessed in both groups. There was no significant difference in the mean age of achievement of neck holding (P-value≥0.05) and rolling over (P-value≥0.05) between the groups. There was significant difference in mean age of achieving sitting (P-value≤0.05), crawling(P-value≤0.05), standing with assistance (P-value ≤0.01), standing without support (P-value ≤0.01) and walking without support (P-value ≤0.01) between the groups. There was one month delay in sitting without support, crawling and standing with assistance in children with clubfoot. There was 3 months delay in standing without support and walking without support. There was significant relation between the crawling (x² =65.511, df=35, P-value =0.001), Standing with assistance (x² =190.583, df=56, P-value=0.000), Standing without support (x²=149.321, df=63, P=value=0.000), Walking without support (x²=156.237, df=63, P-value=0.000) and the age of start of the treatment in the children with clubfoot. Children with clubfoot who started their treatment between the age of 1-3 months had delay in crawling and sitting and those who started their treatment after the age of 6 months but before 12 months had delay in standing with assistance, standing without support and walking without support.

Conclusions: It has been concluded that children with clubfoot have developmental delay as compared to their normal siblings and it is associated with age of start of the treatment.

Implications: The results of study will improve the clinical practice of clinicians working in clubfoot management and they will use holistic approach while dealing with idiopathic clubfoot. Further studies are required to evaluate the association between the milestone development, severity of clubfoot and brace compliance.

Funding acknowledgements: None

Keywords:
Clubfoot
Developmental Milestone
Ponseti method

Topics:
Paediatrics
Musculoskeletal: lower limb
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: Muzaffarabad Physical Rehabilitation Centre, Muzaffarabad AJ&K, Pakistan.

Committee: MPRC ethical committee

Ethics number: 1623/Admin/2022