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The effectiveness of parent manipulation on newborns with postural clubfoot: a randomized controlled trial
Insights
Parent manipulation showed no significant difference in treating newborn postural clubfoot compared to no treatment. Most cases resolved spontaneously within one year, regardless of intervention.
Area of Science:
- Pediatrics
- Orthopedics
- Neonatal Care
Background:
- Postural clubfoot is a common congenital condition in newborns.
- Early intervention is often considered for clubfoot treatment.
- The effectiveness of parent-led manipulation requires investigation.
Purpose of the Study:
- To evaluate the efficacy of parent manipulation versus no treatment for postural clubfoot in infants.
- To compare treatment outcomes in a randomized controlled trial setting.
Main Methods:
- A randomized controlled trial included 92 healthy newborns with postural clubfoot.
- Group A received parent manipulation (≥20/day), Group B received no treatment.
- Outcomes were assessed via physical examination at 1, 3, and 4 months, with a 1-year follow-up.
Main Results:
- No statistically significant difference in success rates between parent manipulation (71.8%) and no treatment (81%) at 4 months (p=0.16).
- Severity of postural clubfoot did not influence outcomes between groups (p=0.3).
- Spontaneous resolution occurred in nearly all cases within one year, with minimal need for casting or orthotics.
Conclusions:
- Parent manipulation for postural clubfoot offers no clinical or statistical advantage over no treatment.
- Spontaneous recovery is the predominant outcome for postural clubfoot within the first year of life.
Objective:
The aim of the present study was to determine the effectiveness of parent manipulation on newborns with postural clubfoot, as compared to newborns that receive no treatment in a randomized controlled trial.
Material And Method:
Ninety-two healthy newborns, including 40 boys and 52 girls, (169 postural clubfeet, including 77 with bilaterally involvement) were included and categorized into two groups by simple randomization using the sealed opaque envelope technique. In Group A, the parent manipulation group, there were 14 boys and 33 girls in 85 postural clubfeet with 38 bilateral involvements. Manipulations were performed at least 20 times per day and the stimulation of the newborn's foot/ feet byparent finger was performed at least 100 times per day. In Group B, the group of newborns receiving no treatment, there were 26 boys and 19 girls in 84 postural clubfeet with 39 bilateral involvements. The follow-up periods for both groups were one, three, and four months after starting the manipulation. The success of the manipulation was measured by the foot appearance, which was normally performed by physical examination.
Results:
A comparison of the characteristics of newborns and parents in both groups showed no statistical differences, except the sex of the newborn. All newborns in both groups were one to six days old. The success rate after 4 months of manipulation in Group A was 71.8%, but it was 81% in Group B with no manipulation; results indicate no statistically significant difference (p = 0.16). The severity of the postural clubfeet indicated no statistical difference in the results of either group (p = 0.3). All cases were followed up at one year with 14% of the studyparticipants dropping out in Group A and 11% dropping out of the study in Group B. All postural clubfeet disappeared in every case within one year of birth except one case in Group A that required casting and one case in Group B that required a prescription for orthopaedic shoes.
Conclusion:
No clinical or statistical differences were found between newborns who received parent manipulation for the treatment of postural clubfoot and newborns who received no treatment. Spontaneous recovery occurred in most of the cases within four months of birth or not more than one year after birth.
