A B M Tuinsma1, B Vanwanseele2, L van Oorschot3, H J J Kars3, L Grin3, M Reijman4, A T Besselaar5, M C van der Steen6. 1. Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA, Eindhoven, The Netherlands. 2. Department of Health Innovation and Technology, Fontys University of Applied Sciences, Ds Theodor Fliednerstraat 2, 5361 BN, Eindhoven, The Netherlands; Department of Kinesiology, KU Leuven, Tervuursevest 101, 3001, Heverlee, Belgium. 3. Department of Health Innovation and Technology, Fontys University of Applied Sciences, Ds Theodor Fliednerstraat 2, 5361 BN, Eindhoven, The Netherlands. 4. Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, The Netherlands; Department of Orthopaedic Surgery, Erasmus MC, University Medical Centre, Postbus 2040, 3000 CA, Rotterdam, The Netherlands. 5. Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA, Eindhoven, The Netherlands; Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, The Netherlands. 6. Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA, Eindhoven, The Netherlands. Electronic address: marieke.vd.steen@catharinaziekenhuis.nl.
Abstract
BACKGROUND: Currently, the Ponseti method is the gold standard for treatment of clubfeet. For long-term functional evaluation of this method, gait analysis can be performed. Previous studies have assessed gait differences between Ponseti treated clubfeet and healthy controls. RESEARCH QUESTION/ PURPOSE: The aims of this systematic review were to compare the gait kinetics of Ponseti treated clubfeet with healthy controls and to compare the gait kinetics between clubfoot patients treated with the Ponseti method or surgically. METHODS: A systematic search was performed in Embase, Medline Ovid, Web of Science, Scopus, Cochrane, Cinahl ebsco, and Google scholar, for studies reporting on gait kinetics in children with clubfeet treated with the Ponseti method. Studies were excluded if they only used EMG or pedobarography. Data were extracted and a risk of bias was assessed. Meta-analyses and qualitative analyses were performed. RESULTS: Nine studies were included, of which five were included in the meta-analyses. The meta-analyses showed that ankle plantarflexor moment (95% CI -0.25 to -0.19) and ankle power (95% CI -0.89 to -0.60, were significantly lower in the Ponseti treated clubfeet compared to the healthy controls. No significant difference was found in ankle dorsiflexor and plantarflexor moment, and ankle power between clubfeet treated with surgery compared to the Ponseti method. SIGNIFICANCE: Differences in gait kinetics are present when comparing Ponseti treated clubfeet with healthy controls. However, there is no significant difference between surgically and Ponseti treated clubfeet. These results give more insight in the possibilities of improving the gait pattern of patients treated for clubfeet.
BACKGROUND: Currently, the Ponseti method is the gold standard for treatment of clubfeet. For long-term functional evaluation of this method, gait analysis can be performed. Previous studies have assessed gait differences between Ponseti treated clubfeet and healthy controls. RESEARCH QUESTION/ PURPOSE: The aims of this systematic review were to compare the gait kinetics of Ponseti treated clubfeet with healthy controls and to compare the gait kinetics between clubfootpatients treated with the Ponseti method or surgically. METHODS: A systematic search was performed in Embase, Medline Ovid, Web of Science, Scopus, Cochrane, Cinahl ebsco, and Google scholar, for studies reporting on gait kinetics in children with clubfeet treated with the Ponseti method. Studies were excluded if they only used EMG or pedobarography. Data were extracted and a risk of bias was assessed. Meta-analyses and qualitative analyses were performed. RESULTS: Nine studies were included, of which five were included in the meta-analyses. The meta-analyses showed that ankle plantarflexor moment (95% CI -0.25 to -0.19) and ankle power (95% CI -0.89 to -0.60, were significantly lower in the Ponseti treated clubfeet compared to the healthy controls. No significant difference was found in ankle dorsiflexor and plantarflexor moment, and ankle power between clubfeet treated with surgery compared to the Ponseti method. SIGNIFICANCE: Differences in gait kinetics are present when comparing Ponseti treated clubfeet with healthy controls. However, there is no significant difference between surgically and Ponseti treated clubfeet. These results give more insight in the possibilities of improving the gait pattern of patients treated for clubfeet.