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The Bangla clubfoot tool: a repeatability study.

Angela Margaret Evans1, Roksana Perveen2, Vikki A Ford-Powell3

  • 1Department of Podiatry, Lower Extremity and Gait Studies (LEGS) Research Program, La Trobe University, Bundoora, Melbourne 3083, Australia ; Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand ; Clinical Services, Walk For Life, Dhaka, Bangladesh.

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A new Bangla clubfoot tool demonstrates excellent reliability for assessing congenital clubfoot deformity in Bangladesh. This tool is vital for the

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Area of Science:

  • Orthopedics
  • Pediatric Medicine
  • Public Health

Background:

  • The 'Walk for Life' (WFL) program in Bangladesh treats congenital clubfoot deformity using the Ponseti technique.
  • Challenges in implementing the Ponseti technique in a low-resource, high-population country necessitate reliable evaluation methods.
  • Over 10,000 children with 16,668 clubfeet have been treated by WFL since 2009, highlighting the need for program evaluation.

Purpose of the Study:

  • To develop a robust and contextually practical tool for evaluating the WFL clubfoot program.
  • To assess the examiner reliability of the developed Bangla clubfoot tool.

Main Methods:

  • The Bangla clubfoot tool was adapted from existing validated measures, incorporating parent satisfaction, gait, and clinical examination.
  • A same-subject repeated measures study design was employed to assess intra-rater reliability.
  • Inter-rater reliability was also evaluated for broader applicability.

Main Results:

  • The study included 37 children (mean age 2.6 years; 28 male: 9 female) treated within two years.
  • Intra-rater reliability was high: ICCs of 0.87 (local examiner) and 0.82 (visiting examiner).
  • Inter-rater reliability was also very good, with an ICC of 0.92.

Conclusions:

  • The Bangla clubfoot tool demonstrates very good intra-rater and inter-rater reliability.
  • The tool is suitable for evaluating the WFL clubfoot program in Bangladesh.
  • This reliable instrument aids in assessing medium and longer-term outcomes for clubfoot treatment in similar contexts.