Human Motion Analysis in Clubfoot
Clubfoot is a deformity in which an infant's foot is turned inward, often so severely that the bottom of the foot faces sideways or even upward. Approximately one infant in every 1,000 live births will have clubfoot, making it one of the more common foot deformities present at birth. OREC's Motion Analysis Laboratories have conducted studies to better understand the dynamics of clubfoot both in children and in young adults. These studies include long-term evaluation of young adults following surgical clubfoot release and assessment of functional treatment outcomes.
To better characterize conservative methods for clubfoot correction, work was done to quantitatively describe cast creep occurring during the treatment process. A comparative study of long-term results compared individuals treated with the more conservative Ponseti method to those who received a comprehensive surgical release. Surgical and non-surgical patients experienced pain, weakness and reduced range of motion; and both groups were highly functional into early adulthood. As adults, however, the patients receiving the Ponseti treatment method fared better than patients receiving surgical treatment due to advantages including increased range of motion (ROM), greater strength, and less arthritis. This series of studies has added to our understanding of clubfoot dynamics and the longer-term effects of surgical vs. conservative treatment options.
Image: Left: Plantar Pressure Pattern from a Participant with Clubfoot during Normal Ambulation. Right: Standing Presentation of Participant with Clubfoot.
Graf, A., Wu, K.W., Smith, P.A., Kuo, K.N., Krzak, J. and Harris, G.: Comprehensive Review of the Functional Outcome Evaluation of Clubfoot Treatment: A Preferred Methodology. Journal of Pediatric Orthopaedics B. 21(1):20–27.
Cohen, T.L., Altiok, H., Wang, M., McGrady, L.M., Krzak, J., Graf, A., Tarima, S., Smith, P.A. and Harris, G.F.: Evaluation of Cast Creep Occurring during Simulated Clubfoot Correction. Journal of Engineering in Medicine, Part H. 227(8):919–927, 2013.
Smith, P.A., Kuo, K.N., Graf, A.N., Krzak, J., Flanagan, A., Hassani, S., Caudill, A.K., Dietz, F.R., Morcuende, J. and Harris, G.F.: Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better? Clinical Orthopaedics and Related Research. 472(4):1281–1290, 2014.
Graf, A., Kuo, K.N., Kurapati, N.T., Hassani, S., Krzak, J.J, Caudill, A., Flanagan, A., Harris, G.F., Smith, P.A.: A Long-Term Follow-up of Young Adults with Idiopathic Clubfoot: Does foot morphology relate to pain?" Journal of Pediatric Orthopaedics. 39(10):527-533.
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