title: Short-term results of intensive physiotherapy in clubfoot deformity treated with the Ponseti method.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The results of this study imply that an intensive physiotherapy program may enhance the effectiveness of the Ponseti protocol.
authors.affiliation: Faculty of Health Sciences, Physical Therapy and Rehabilitation Department, Hacettepe University, Ankara, Turkey. nilbek@hacettepe.edu.tr
authors.forename: Bek
authors.initials: B
authors.lastname: Nilgün
authors.forename: Erel
authors.initials: E
authors.lastname: Suat
authors.forename: Simşek İbrahim
authors.initials: Sİ
authors.lastname: Engin
authors.forename: Uygur
authors.initials: U
authors.lastname: Fatma
authors.forename: Yakut
authors.initials: Y
authors.lastname: Yakut
mesh_terms: D002370:Casts, Surgical; D002675:Child, Preschool; D003025:Clubfoot / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome