Community Ambulatory Activity in Children Treated for Clubfoot: 10-year Follow-up

Area of Science:

• Orthopedics
• Pediatric Health
• Biomechanical Engineering

Background:

• Nonoperative treatment for idiopathic clubfoot is globally adopted for improved physical function.
• Current outcome assessments often rely on lab-based gait data, which may not reflect community physical activity.
• This study investigates community ambulation quality in children with nonoperatively treated idiopathic clubfoot.

Purpose of the Study:

• To assess community ambulation intensity, duration, and volume in children with idiopathic clubfoot treated nonoperatively.
• To compare physical activity levels between children with clubfoot and a typically developing control group.

Main Methods:

• 103 children treated for idiopathic clubfoot and a control group wore step activity monitors at age 10.
• Evaluated total steps, ambulatory time, intensity, duration, and volume of physical activity.
• Compared activity metrics and participation in competitive sports between groups.

Main Results:

• Clubfoot patients averaged ~1,300 fewer steps and 40 minutes less ambulation daily (P=.005).
• Competitive sports participation was lower in clubfoot patients (35%) vs. controls (63%) (P=.013).
• Clubfoot patients in sports had fewer weekday steps but higher Global Function scores than non-participating clubfoot patients (P=.047).

Conclusions:

• Children with clubfoot exhibit reduced daily steps, ambulation time, and lower engagement in competitive sports compared to typically developing peers.
• Real-world activity monitoring provides valuable insights into functional impairments affecting daily life for children with clubfoot.
• Findings underscore the need for interventions addressing community-level physical activity deficits in pediatric clubfoot patients.