Causes of Non-compliance of Foot Abduction Orthosis amongst Local Patients of Relapse Idiopathic Club Foot

Abid  Rashid; Armghan  Anjum; Sultan Mehmood Khan; Farhan  Sarwar; Abdul Latif Sam; Muhammad Mudassar Ashraf; Syed Rehan Iftikhar Bukhari; Awais Bin Inam; Ramiza  Khalid; Muhammad Adnan Sarwar

doi:10.29054/apmc/2017.245

Abid Rashid Professor, College of Physical Therapy, Directorate of Medical Sciences, Government College University, Faisalabad
Armghan Anjum Lecturer, College of Physical Therapy, Directorate of Medical Sciences, Government College University, Faisalabad
Sultan Mehmood Khan Assistant Professor, Surgical Unit–III, PMC /Allied Hospital, Faisalabad
Farhan Sarwar Senior Registrar of Orthopedics, Allied Hospital, Faisalabad
Abdul Latif Sam Department of Pediatrics Orthopedics, Children Hospital and Institute of Child Health, Lahore
Muhammad Mudassar Ashraf Assistant Professor, Eastern Medicine Directorate of Medical Sciences, Government College University, Faisalabad
Syed Rehan Iftikhar Bukhari Lecturer, College of Physical Therapy, Directorate of Medical Sciences, Government College University, Faisalabad
Awais Bin Inam Lecturer, College of Physical Therapy, Directorate of Medical Sciences, Government College University, Faisalabad
Ramiza Khalid Lecturer, College of Physical Therapy, Directorate of Medical Sciences, Government College University, Faisalabad
Muhammad Adnan Sarwar Senior Registrar, Medicine DHQ Civil Hospital, Faisalabad

DOI: https://doi.org/10.29054/apmc/2017.245

Keywords: Clubfoot, Ponseti, Males, Females, Multiple reasons

Abstract

Background: Clubfoot is the most common lower extremity birth defect. It causes the feet of affected individuals to point inward and downward thus preventing them from walking normally. Its treatment ranges from gentle manipulation to less invasive surgery. Foot abduction orthosis is the major method of manipulating the clubfoot, which consists of taping the foot onto a bar to maintain the position obtained by manipulation. Objective: The purpose of present study was to determine the causes of non-compliance of foot abduction orthosis amongst relapsed idiopathic clubfoot patients. Study Design: Retrospective cohort study. Sampling Technique: Non- probability, purposive sampling technique. Setting: Study was conducted in Outdoor Patient Department (OPD), Paediatric Orthopaedics Department, The Children Hospital and Institute of Child Health, Lahore after ethical approval from committee on research ethics of relevant institute. Sample Size: A Sample size of 67 patients was estimated by using 90% confidence level, 1% margin of error with expected %age of compliance (CTEV) as 6 %. Methods: Total 67 patients (45 males and 22 females) of age between 1-5 years were selected by non-probability, purposive sampling technique. Dimeglio scoring system was used for evaluation of relapsed deformity. Goniometer was used to check ROM of foot. An approved questionnaire based on the causes for non-compliance of foot abduction orthosis was used for data collection. Data was obtained and percentage of different factors causing non-compliance of foot abduction orthosis amongst relapse idiopathic clubfoot patients was calculated. Results: The main causes of non-compliance were financial problems 24(35.82%)M and 10(14.92%)F; emotional reasons of parents 25(37.31%) M(male) and 11(16.41%)F (female); ignorance 12(17.91%)M and 08(11.94%)F; skin problems 15(22.38%)M and 05(7.26%)F; swelling & redness 12(17.91%)M and 10(14.92%)F; infection 05(7.26%)M and 05 (7.26%)F and lack of cosmesis 13(19.40%)M and 05(7.26%)F. Patients (62 out of 67) with multiple reasons were also found. Conclusions: It was concluded that major causes of non-compliance in both males and females were financial problems and emotional reasons of parents during manipulation, whereas, the least cause of non-compliance in both males and females was infection.