Factors affecting adherence with foot abduction orthosis following Ponseti method

Yıl 2015, Cilt: 49 Sayı: 6, 620 - , 28.10.2015

Suleyman Goksan Fuat Bilgili Ilker Eren , Aysegul Bursali , Eylem Koc

Öz

Objective: The Ponseti method is an effective protocol for treatment of congenital idiopathic clubfoot. Foot abduction orthosis (FAO) is sometimes necessary to preserve the correction achieved with the serial casting and tenotomy. Patient and family adherence to brace use is a common problem, as nonadherence is directly related to relapse. The aim of this study was to investigate patient and parent characteristics related to relapse.
Methods: One hundred and fifty-three children who were treated with Ponseti method (mean age: 44.62 months; range: 16–104 months) and their parents were included in the study. Thirty-one patients experienced relapse at an average follow-up of 32 months (range: 6–84 months) since beginning orthosis use. At the time of follow-up visits, parents were questioned about brace use adherence. Satisfaction with Symptoms Scale in the American Academy of Orthopaedic Surgeons (AAOS) Pediatric Outcomes Data Collection Instrument (PODCI) was used.
Results: Difficulties with brace use were encountered in 122 children. Children of parents who were satisfied with the treatment had relapse at an average of 69.13±2.64 months, and those of parents who were not satisfied at 32.83±7.51 months. The most important variable was the child’s adaptation to the orthosis treatment without an adverse reaction. Additionally, better compliance was found in children with higher-educated parents.
Conclusion: Non-compliance with periods of intolerance is very common for children during orthosis treatment. Parents’ coping strategies are very important to avoid relapses. It is important to develop strategies to guide parents.

DOI: 10.3944/AOTT.2015.14.0348

Anahtar Kelimeler

Adherence; clubfoot; foot abduction orthosis; Ponseti method.

Kaynakça

• Dobbs MB, Rudzki JR, Purcell DB, Walton T, Porter KR, Gurnett CA. Factors predictive of outcome after use of the Ponseti method for the treatment of idiopathic clubfeet. J Bone Joint Surg Am 2004;86-A:22–7.
• Vitale MG, Choe JC, Vitale MA, Lee FY, Hyman JE, Roye DP Jr. Patient-based outcomes following clubfoot surgery: a 16-year follow-up study. J Pediatr Orthop 2005;25:533–8.
• Zionts LE, Dietz FR. Bracing following correction of id- iopathic clubfoot using the Ponseti method. J Am Acad Orthop Surg 2010;18:486–93.
• Thacker MM, Scher DM, Sala DA, van Bosse HJ, Feld- man DS, Lehman WB. Use of the foot abduction orthosis following Ponseti casts: is it essential? J Pediatr Orthop 2005;25:225–8.
• Morgenstein A, Davis R, Talwalkar V, Iwinski H Jr, Walker J, Milbrandt TA. A randomized clinical trial comparing reported and measured wear rates in clubfoot bracing using a novel pressure sensor. J Pediatr Orthop 2015;35:185–91.
• Haft GF, Walker CG, Crawford HA. Early clubfoot re- currence after use of the Ponseti method in a New Zea- land population. J Bone Joint Surg Am 2007;89:487–93.
• Cooper DM, Dietz FR. Treatment of idiopathic club- foot. A thirty-year follow-up note. J Bone Joint Surg Am 1995;77:1477–89.
• Colburn M, Williams M. Evaluation of the treatment of idiopathic clubfoot by using the Ponseti method. J Foot Ankle Surg 2003;42:259–67.
• Göksan SB, Bursali A, Bilgili F, Sivacioğlu S, Ayanoğlu S. Ponseti technique for the correction of idiopathic clubfeet presenting up to 1 year of age. A preliminary study in chil- dren with untreated or complex deformities. Arch Orthop Trauma Surg 2006;126:15–21.
• Abdelgawad AA, Lehman WB, van Bosse HJ, Scher DM, Sala DA. Treatment of idiopathic clubfoot using the Pon- seti method: minimum 2-year follow-up. J Pediatr Orthop B 2007;16:98–105.
• Bor N, Coplan JA, Herzenberg JE. Ponseti treatment for idiopathic clubfoot: minimum 5-year followup. Clin Or- thop Relat Res 2009;467:1263–70.
• Richards BS, Faulks S, Rathjen KE, Karol LA, Johnston CE, Jones SA. A comparison of two nonoperative meth- ods of idiopathic clubfoot correction: the Ponseti meth- od and the French functional (physiotherapy) method. J Bone Joint Surg Am 2008;90:2313–21.
• Morin ML, Hoopes DM, Szalay EA. Positive commu- nication paradigm decreases early recurrence in clubfoot treatment. J Pediatr Orthop 2014;34:219–22.
• Noonan KI. Ponseti technique in the treatment of club- foot, in Master Techniques in Orthopaedic Surgery: Pedi- atrics, Tolo VT and Skaggs DL, Editors. Lippincott Wil- liams & Wilkins 2008.