Fysioterapeuten (Jan 2020)
The Ponseti Method: With or Without Intensive Manual Stretching. A Single Subject Design Study
Abstract
Background: Several Norwegian hospitals include manual stretching exercises in addition to the Ponseti Method in the treatment of clubfoot, but there is sparse evidence documenting the efficacy of manual stretching. Objective: To evaluate whether a period without manual stretching reduces ankle joint and foot mobility in clubfeet treated with the Ponseti Method. Methods: A single subject design study (SSD) was conducted. Babies between 3 and 12 months born with clubfeet were eligible. The outcome measures were angles in ankle dorsiflexion, ankle plantarflexion, total range of motion (ROM) in the ankle joint and forefoot adduction angle. Outcome measures were taken frequently before, during and after the intervention by goniometer. The outcome measures are illustrated graphically in order to evaluate changes over time. Results: Five clubfeet were included. The results showed a trend towards reduced dorsiflexion and total ROM for the whole period without any visual changes in the intervention period. Conclusion: A period of 4 weeks without manual stretching seemed to not influence ankle joint mobility in babies born with clubfoot who were treated with the Ponseti Method. Randomized controlled trials are needed to evaluate the efficacy of manual stretching.
