The effectiveness of parent manipulation on newborns with postural clubfoot: A randomized controlled Trial

Abstract

© 2014, Medical Association of Thailand. All Rights Reserved. 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 by parent 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 study participants 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.