Follow-up of children with congenital clubfoot. Development of a new evaluation instrument.

Hanneke Andriesse

Research output: ThesisDoctoral Thesis (compilation)

368 Downloads (Pure)

Abstract

Clubfoot is a congenital disorder, affecting about one of 1000 children. Treatment consists of initial correction of the deformity, followed by prolonged orthosis treatment to maintain the correction obtained. There are several different treatment options. Outcome studies, using reliable and valid instruments are rare.

In this thesis an assessment instrument, Clubfoot Assessment Protocol (CAP) was developed for longitudinal follow up of children with clubfoot. The CAP provides information on the development of different functional domains (mobility, muscle function, morphology and motion quality) over time. The reliability, validity, responsiveness and clinical utility was analysed in a prospective sample of 73 consecutive children. The clinical utility was analysed by comparing Ponseti casting technique vs Copenhagen stretching method and by studying developmental motor problems in children born with clubfoot.

The methodological studies showed that the CAP can be used with sufficient reliability and validity. For research purposes, experience of the CAP and data on actual inter observer differences should be described. The CAP showed a stronger ability to discriminate foot status than the Dimeglio Classification system (DCS). The CAP is more sensitive to change especially in the moderate to severe range. Thus, the CAP is an important contribution to clubfoot evaluation in clinical and in research settings.

The casting technique according to Ponseti was superior in clubfoot correction regarding mobility and motion quality according to the CAP at age two years. Furthermore, less surgery was needed. The orthosis management showed maintenance or slight improvement of the clinical status along with good compliance.

Developmental motor ability problems were found more often than expected among seven year old children treated for idiopathic clubfoot. This finding could not be explained by previous surgery or foot function. The ability to stand on one leg correlated strongest to motor problems and could serve as a screening test in clinical settings of clubfoot evaluation.
Original languageEnglish
QualificationDoctor
Awarding Institution
  • Human Movement: health and rehabilitation
Supervisors/Advisors
  • Hägglund, Gunnar, Supervisor
  • JARNLO, GUN-BRITT M, Supervisor
Award date2007 Sep 14
Publisher
ISBN (Print)978-91-85897-01-8
Publication statusPublished - 2007

Bibliographical note

Defence details

Date: 2007-09-14
Time: 09:00
Place: Segerfalksalen, BMC, Universitetssjukhuset, Lund.

External reviewer(s)

Name: Haglund-Åkerlind, Yvonne
Title: docent
Affiliation: Astrid Lindgrens Barnsjukhus, Stockholm

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<div class="article_info">Hanneke Andriesse, Gunnar Hägglund and Gun-Britt Jarnlo. <span class="article_issue_date">2005</span>. <span class="article_title">The Clubfoot Assessment Protocol (CAP; Description and reliability of a structured multi-level instrument for follow-up</span> <span class="journal_volume">vol 6</span> <span class="journal_pages">pp 8</span>. <span class="journal_distributor">BMC Musculoskeletal Disorders</span></div>
<div class="article_info">Hanneke Andriesse, Ewa M Roos, Gunnar Hägglund and Gun-Britt Jarnlo. <span class="article_issue_date">2006</span>. <span class="article_title">Validity and responsiveness of the Clubfoot Assessment Protocol (CAP). A methodological study</span> <span class="journal_volume">vol 7</span> <span class="journal_pages">pp 8</span>. <span class="journal_distributor">BMC Musculoskeletal Disorders</span></div>
<div class="article_info">Hanneke Andriesse and Gunnar Hägglund. <span class="article_issue_date"></span>. <span class="article_title">Comparison of serial casting versus stretching technique in children with congenital idiopathic clubfoot</span> <span class="journal_pages">pp 10</span>. <span class="journal_distributor">Department of orthopedics, Lund</span> (accepted)</div>
<div class="article_info">Hanneke Andriesse, Lena Westbom, Gun-Britt Jarnlo and Gunnar Hägglund. <span class="article_issue_date"></span>. <span class="article_title">Developmental disorder of motor function in children treated for idiopathic clubfoot?</span> <span class="journal_pages">pp 10</span>. <span class="journal_distributor">Department of Orthopaedics, Lund Division of Physiotherapy, Lund</span> (submitted)</div>
<div class="article_info">Hanneke Andriesse, Gunnar Hägglund and Per-Erik Isberg. <span class="article_issue_date"></span>. <span class="article_title">Reliability of motion analysis in children treated for congenital clubfoot</span> <span class="journal_pages">pp 10</span>. <span class="journal_distributor">Department of Orthopaedics, Lund</span> (submitted)</div>


The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Division of Physiotherapy (Closed 2012) (013042000)

Subject classification (UKÄ)

  • Physiotherapy

Keywords

  • Validity
  • Assessment instrument
  • Clubfoot
  • Reliability
  • Responsivenss
  • Treatment evaluation
  • Developmental motor ability
  • Skeleton
  • rheumatology locomotion
  • muscle system
  • muskelsystem
  • Skelett
  • Surgery
  • reumatologi
  • traumatologi
  • Rehabilitering (medicinsk och social)
  • rehabilitation
  • revalidation
  • kinesitherapy
  • Physical medicine
  • orthopaedics
  • traumatology
  • Kirurgi
  • ortopedi

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