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

Nonoperative treatment of clubfoot deformity has been embraced globally due to enhanced physical function following treatment. To date, quantification of functional outcomes in children with clubfoot has focused largely on gait data collected in a laboratory setting; however, this focus is likely unrepresentative of physical activities performed in the community. This study aimed to assess the quality of community ambulation (intensity, duration, and volume) in children treated nonoperatively for idiopathic clubfoot.

At 10 years of age, patients treated for idiopathic clubfoot (n = 103) were invited to wear a step activity monitor for tracking their physical activity participation. Global measures including total steps and total ambulatory time were evaluated in terms of intensity, duration, and volume (intensity + duration) and compared to a typically developing control group.

When compared to the control group, children with clubfoot recorded ∼1,300 fewer steps and 40 less total minutes of ambulation each day (P = .005). Moreover, participation in competitive sports was reported by only 35% of clubfoot children versus 63% of controls (P = .013). Patients with clubfoot who engaged in competitive sports still took significantly fewer weekday steps than controls participating in competitive sports but had higher reported Global Function scores than those who did not (P = .047).

Step activity metrics demonstrate that clubfoot patients take less steps, spend less number of steps ambulating, and are less likely to engage in competitive athletics than their healthy peers. Such real-world metrics help clinicians better understand the impact functional impairments have on daily childhood activity.

(1)Children with clubfoot record fewer steps and less total minutes of ambulation each day than their typically developing peers.(2)Participation in competitive sports was reported by only 35% of clubfoot children versus 63% of controls.(3)Patients with clubfoot who engaged in competitive sports still took significantly fewer weekday steps than their typically developing peers but had higher reported Global Function scores than those who did not participate in sports.(4)Real-world metrics help clinicians better understand the impact functional impairments have on daily childhood activity.

Level II.