262,398 research outputs found
The long-term functional and radiographic outcomes of untreated and non-operatively treated metatarsus adductus
No full textThirty-one patients (forty-five feet) who had metatarsus adductus were evaluated at our institution and were followed for an average of thirty-two years and six months. Of these thirty-one patients, twenty-one (thirty-one feet) were examined clinically and radiographically. Information on the remaining ten patients (fourteen feet) was obtained by letter or telephone, or both. Twelve patients (sixteen feet) who had a passively correctable deformity (mild or moderate) at the time of the initial presentation had no treatment. Twenty patients (twenty-nine feet) who had a partly flexible or rigid deformity (moderate or severe) at the time of the initial presentation were managed with serial manipulation and application of plaster holding casts. (One patient who had a bilateral deformity had no treatment on one side and conservative management on the other). The results were good in all sixteen of the untreated feet and in twenty-six (90 per cent) of the twenty-nine feet that had been conservatively treated. There were no poor results. The passively correctable deformities resolved spontaneously. Radiographs showed an obliquity of the medial cuneiform-metatarsal joint in twenty-one (68 per cent) of the thirty-one feet that were examined clinically and radiographically. Similar findings were observed in four of eleven contralateral, normal feet. Hallux valgus was not a common outcome. No patient had operative correction
The Ponseti Method: With or Without Intensive Manual Stretching. A Single Subject Design Study
No full textBakgrunn: Mange norske sykehus har integrert intensive manuelle tøyninger i tillegg til Ponseti-metoden i behandlingen av klumpfot, men det er lite dokumentasjon
på om tøyningene har effekt.
n Hensikt: Hensikten var å undersøke om en periode uten disse manuelle tøyningene
reduserer ankel- og fotbevegelighet i klumpføtter som blir behandlet med Ponsetimetoden.
n Metode: Single subject design (SSD). Tre babyer mellom tre og 12 måneder født med
totalt fem klumpføtter ble inkludert i studien. Utfallsmålene var grader av dorsalfleksjon, plantarfleksjon, totalt bevegelsesutslag i ankelleddet og forfotsadduksjon.
Intervensjonen varte i fire uker. Hyppige målinger med goniometer ble gjort før,
under og etter intervensjonen.
n Resultater: Resultatene viser en trend mot redusert dorsalfleksjon og totalt bevegelsesutslag i hele perioden uten noen tydelige forandringer i intervensjonsperioden.
n Fortolkning: En periode på fire uker uten intensive manuelle tøyninger så ikke ut
til å ha innvirkning på ankelbevegeligheten i klumpføtter som ble behandlet med
Ponseti-metoden. Randomiserte kontrollerte studier er nødvendige for å evaluere
effekten av manuelle tøyninger på klumpføtter.Background: Several Norwegian hospitals include manual stretching exercises in addition to the Ponseti Method in the treatment of clubfoot, but there is sparse evidence
documenting the efficacy of manual stretching. Objective: To evaluate whether a period without manual stretching reduces ankle joint and foot mobility in clubfeet treated with the Ponseti Method. Methods: A single subject design study (SSD) was conducted. Babies between 3 and 12 months born with clubfeet were eligible. The outcome measures were angles in
ankle dorsiflexion, ankle plantarflexion, total range of motion (ROM) in the ankle joint and forefoot adduction angle. Outcome measures were taken frequently before, during and after the intervention by goniometer. The outcome measures are illustrated graphically in order to evaluate changes over time.
Results: Five clubfeet were included. The results showed a trend towards reduced
dorsiflexion and total ROM for the whole period without any visual changes in the
intervention period.
Conclusion: A period of 4 weeks without manual stretching seemed to not influence
ankle joint mobility in babies born with clubfoot who were treated with the Ponseti
Method. Randomized controlled trials are needed to evaluate the efficacy of manual
stretching.publishedVersio
En single subject design studie: Ponseti-metoden – med eller uten intensivemanuelle tøyninger
No full textBakgrunn: Mange norske sykehus har integrert intensive manuelle tøyninger i tillegg til Ponseti-metoden i behandlingen av klumpfot, men det er lite dokumentasjon
på om tøyningene har effekt.
n Hensikt: Hensikten var å undersøke om en periode uten disse manuelle tøyningene
reduserer ankel- og fotbevegelighet i klumpføtter som blir behandlet med Ponsetimetoden.
n Metode: Single subject design (SSD). Tre babyer mellom tre og 12 måneder født med
totalt fem klumpføtter ble inkludert i studien. Utfallsmålene var grader av dorsalfleksjon, plantarfleksjon, totalt bevegelsesutslag i ankelleddet og forfotsadduksjon.
Intervensjonen varte i fire uker. Hyppige målinger med goniometer ble gjort før,
under og etter intervensjonen.
n Resultater: Resultatene viser en trend mot redusert dorsalfleksjon og totalt bevegelsesutslag i hele perioden uten noen tydelige forandringer i intervensjonsperioden.
n Fortolkning: En periode på fire uker uten intensive manuelle tøyninger så ikke ut
til å ha innvirkning på ankelbevegeligheten i klumpføtter som ble behandlet med
Ponseti-metoden. Randomiserte kontrollerte studier er nødvendige for å evaluere
effekten av manuelle tøyninger på klumpføtter
Ansietat i valors a l'aula d'EF i a les activitats extraescolars
No full text[cat] Durant aquest article, el que es vol tractar, és la quantitat d’emocions i sentiments negatius que poden percebre els alumnes durant la seva edat escolar, tant a nivell educatiu (intel·lectualment parlant) com a nivell físic (dins les aules d’Educació Física i altres activitats extraescolars).
Per aquest motiu, durant l’estudi s'analitzaran les relacions existents entre l'ansietat competitiva, en les seves facetes cognitiva i somàtica, i els valors en la pràctica esportiva en una escola durant les sessions d’educació física i les activitats extraescolars proposades pel centre. Els participants d’aquest estudi varen ser 100 esportistes (50 alumes d’activitats extraescolars i 50 alumnes de les aules d’Educació Física). Per valorar l'ansietat, es va utilitzar els qüestionari SAS-2 (Ramis, Torregrosa, Viladrich i Cruz, 2010) veure a l’annex 1, i per valorar l'ús de l'astúcia i l'engany, el CDED (Ponseti, 2012), veure a l’annex 2. Finalment, aquests resultats es discuteixen i es comparen amb altres similars en poblacions preadolescents.
Baix el meu punt de vista, les classes d’Educació Física no és una classe comú a la resta, per tant, crea un altre tipus de relació entre companys, més afectiva. Llavors, els alumnes davant un estímul, poden reaccionar d’una forma o d’una altre, es a dir, segons el caire de cada alumne i la relació alumne-classe, poden arribar a no complir les normes i per tant que el joc no funcioni totalment. Per això, és important deixar clares les normes, intentar complir-les i crear uns valors adequats per a tothom.
Llavors, és normal que els infants desenvolupin certes pors i experimentin sensacions temoroses davant diferents problemes, durant el seu desenvolupament. Amb el temps, les pors normals desapareixen quan els alumnes aprenen més sobre allò que s’espera de l’entorn i de les relacions amb altres persones. Quan les seves pors no se’n van i comencen a intervenir dins la vida personal i les activitats diàries de l’infant, pot ser considerat com a trastorn d'ansietat.[eng] During this article, to be treated, is the amount of negative feelings and emotions that can perceive the students during their school age , both educational (intellectually speaking) as physical (within Physical education classrooms and other school activities). For this reason, during the study analyzed the relationship between competitive anxiety in somatic and cognitive facets and values in sports in school during the sessions of physical education and extracurricular activities proposed the middle. The participants of this study were 100 athletes (50 alum extracurricular activities and 50 students of the classroom physical education). To assess the anxiety questionnaire was used the SAS -2 (Ramis, Torregrosa, Viladrich and Cruz, 2010), and evaluate the use of cunning and deceit , the CDED (Ponseti, 2012). Finally, these results are discussed and compared with similar population tweens.
Under my point of view, the Physical Education classes is a common class to the other, thus creating a different kind of relationship between colleagues, more emotional. Then, students face a stimulus, can react in one way or another, that is, according to the nature of each student and student-class ratio, they can not meet the standards and therefore the game not function fully. Therefore, it is important to clarify the rules, try to fulfill them and create appropriate values for everyone. So it is normal that children develop fears and experience some fearful feelings to different problems during development. Over time, normal fears disappear when students learn more about what is expected of the surroundings and relationships with others. When their fears do not go away and begin to intervene in the personal lives and daily activities of the child can be considered as anxiety disorder
An accelerated Ponseti <i>versus</i> the standard Ponseti method
No full text We conducted a prospective randomised controlled trial to compare the standard Ponseti plaster method with an accelerated method for the treatment of idiopathic congenital talipes equinovarus. The standard weekly plaster-change method was accelerated to three times per week. We hypothesised that both methods would be equally effective in achieving correction. A total of 40 consecutive patients (61 feet) were entered into the trial. The initial median Pirani score was 5.5 (95% confidence interval 4.5 to 6.0) in the accelerated group and 5.0 (95% confidence interval 4.0 to 5.0) in the standard control group. The scores decreased by an average 4.5 in the accelerated group and 4.0 in the control group. There was no significant difference in the final Pirani score between the two groups (chi-squared test, p = 0.308). The median number of treatment days in plaster was 16 in the accelerated group and 42 in the control group (p < 0.001). Of the 19 patients in the accelerated group, three required plaster treatment for more than 21 days and were then assigned to the standard control method. Of the 40 patients, 36 were followed for a minimum of six months. These results suggest that comparable outcomes can be achieved with an accelerated Ponseti method. The ability to complete all necessary manipulations within a three-week period facilitates treatment where patients have to travel long distances. </jats:p
Pes ekinovaruslu hastaların ponseti yöntemi ile tedavisi
No full textBiz bu çalışmada kliniğimizde 2006 ve 2010 yılları arasında Dicle Üniversitesi Ortopedi ve Travmatoloji Anabilim Dalında idiopatik PEV tanısı konan ve ponseti yöntemiyle tedavi edilen, en küçüğü 4 günlük en büyüğü 42 ay(ortalama 9,2 ay) 35 hastanın 60 ayağının sonuçlarını değerlendirdik. 35 hastanın 7'si kız, 28'i erkek idi. 10 hastada tek taraflı tutulum(2 sol- 8 sağ), 25 hastada çift taraflı tutulum vardı. Takip süresi minimum 12ay maksimum 50 ay olmak üzere ortalama 28,8 ay idi. Tedaviye başlamadan önce Dimeglio ve arkadaşlarının kullandığı PEV değerlendirme sistemi kullanıldı. Tedavi öncesi 41 ayak(%68,3) 2. derece 19 ayak(%31,7) III. derece idi. Tedavi sonrası muayenede Laaveg-Ponseti fonksiyon değerlendirme skorlaması ve Dimeglio skorlaması yapıldı. Ponseti-Laaveg Fonksiyonel değerlendirme skorlamasına göre ponseti yöntemi ile tedavi ettiğimiz 60 ayağın %96,7 `sinde iyi veya mükemmel bir sonuç alındı. Dimeglio sınıflamasına göre tedavi sonrası hastalarımızın %93,3 grade 1 idi. Hastalarımızda tespit ettiğimiz en sık komplikasyon metatarsus adduktus %15 (9ayak) idi. Hastalarımızda ortez uyumu fonksiyonel sonuç ve komplikasyon ile yakından ilişkili bulundu. Ponseti yöntemi PEV tedavisinde etkili ve tekrarlanabilir bir yöntemdir. Başarılı bir sonuç için tekniği aslına uygun olarak yapılmalıdır. Tedavinin bir diğer unsuru başarılı bir sonuç almak için ayak abdüksiyon ortezine uyum gösterilmesi şarttır.In this study, Dicle University between 2006 and 2010 at the Department of Orthopedics and Traumatology, PEV was diagnosed as idiopathic and treated with the Ponseti method, the youngest of the largest of the 4-day 42 months (mean 9,2months) 35 patients were evaluated results of 60 feet. 7 of 35 patients were girls and 28 were male. One-sided involvement in 10 patients (2 left - 8 right), 25 patients had bilateral involvement. A minimum of 12 months follow-up period, including a maximum of 50 months, mean 28,8 months. Before starting treatment, and his colleagues used Dimeglio; PEV assessment system used. Before the treatment, 41 feet were (68,3%) 2 degrees 19 feet were (31,7%) III. degrees. After the treatment, Dimeglio and Laveg-Ponseti Function Assessment scores were scored.According to Ponseti-Laveg Functional Assessment scoring 60 of the foot treated with the Ponseti method, 96,7% percent were treated in good or excellent result. According to Dimeglio classification; after treatment the patients was 93,3% grade 1. The most common complication in our patients, we've found, 15% of metatarsus adductus (9 feet) were. Closely associated with functional outcome and complications in our patients was found in compliance with orthotic. Ponseti method is effective and reproducible method for the treatment of PEV. Ponseti method should be done correctly for a successful outcome. The other element of a successful outcome of treatment for foot must show compliance the abduction orthotic
Spanish adaptation and validation of the Laaveg-Ponseti score
No full textilustraciones, gráficas, tablasIntroducción: La puntuación de Laaveg-Ponseti es una herramienta utilizada para evaluar los resultados del tratamiento de los pacientes con diagnóstico de pie equino varo congénito. El propósito de este estudio es realizar la traducción, adaptación cultural y validación en español de la puntuación de Laaveg-Ponseti para evaluar los resultados posteriores al tratamiento en los pacientes del habla castellana. Metodología: Estudio metodológico tipo validación de escala, en el cual mediante un método estructurado se realizó la traducción y validación de una herramienta de investigación tipo encuesta. En el estudio participaron 70 pacientes con diagnóstico de pie equino varo congénito tratados en un hospital de cuarto nivel en la ciudad de Bogotá. Resultados: la versión del cuestionario traducido al español presentó muy buena validez interna con un alfa de Cronbach estandarizado de 0.84, concordancia muy buena con un kappa de 0.993 y una correlación intraclase muy buena de 0.995. Conclusión: el puntaje de Laaveg-Ponseti presenta una buena validación intragrupo, con una muy buena correlación intraclase y concordancia muy buena, por lo cual se considera un cuestionario adecuado para utilizar en los pacientes de habla hispana. (Texto tomado de la fuente).Introduction: The Laaveg-Ponseti score is a tool used to evaluate the results of treatment of patients diagnosed with congenital clubfoot. The purpose of this study is to perform the translation, cultural adaptation, and Spanish validation of the Laaveg-Ponseti score to assess post-treatment outcomes in Spanish-speaking patients. Methodology: Scale validation methodological study, in which the translation and validation of a survey-type research tool was carried out using a structured method. The study involved 70 patients diagnosed with congenital clubfoot treated at a fourth-level hospital in the city of Bogotá. Results: The version of the questionnaire translated into Spanish presented very good internal validity with a standardized Cronbach's alpha of 0.84, very good concordance with a kappa of 0.993, and a very good intraclass correlation of 0.995. Conclusion: The Laaveg-Ponseti score presents good intragroup validation, with very good intraclass correlation and very good concordance, which is why it is considered an appropriate questionnaire to use in Spanish-speaking patients.Especialidades MédicasEspecialista en Ortopedia y TraumatologíaOrtopedia Pediátric
CLUBFOOT RECCURENCES AFTER THE TREATMENT BY PONSETI
No full textCongenital clubfoot is one of the most frequent pathologies of the musculoskeletal system. The treating of clubfoot by Ponseti gives promising results and complete correction of the deformity in 90-95% of patients sparing them from extensive surgery. In the Yaroslavl Regional Children's Hospital from May 2006 to December 2007 54 children (83 feet) with severe congenital clubfoot were treated. Treatment for all patients was initiated at the age of 1 year. With remote monitoring for 5 years recurrences were noted in 19.3% of cases. Despite its high efficacy in patients under the age of three years, non-compliance of brace wearing results in the number of recurrences and require re-gypsum. In older children (3 to 5 years) the treatment by Ponseti is supplemented by transfer of tibialis anterior muscle tendon. In cases of postoperative recurrence of the treatment program is complemented by local releases and arthrodesis
CLUBFOOT RECCURENCES AFTER THE TREATMENT BY PONSETI
No full textCongenital clubfoot is one of the most frequent pathologies of the musculoskeletal system. The treating of clubfoot by Ponseti gives promising results and complete correction of the deformity in 90-95% of patients sparing them from extensive surgery. In the Yaroslavl Regional Children's Hospital from May 2006 to December 2007 54 children (83 feet) with severe congenital clubfoot were treated. Treatment for all patients was initiated at the age of 1 year. With remote monitoring for 5 years recurrences were noted in 19.3% of cases. Despite its high efficacy in patients under the age of three years, non-compliance of brace wearing results in the number of recurrences and require re-gypsum. In older children (3 to 5 years) the treatment by Ponseti is supplemented by transfer of tibialis anterior muscle tendon. In cases of postoperative recurrence of the treatment program is complemented by local releases and arthrodesis.</jats:p
From Cutting to Casting: Impact and Initial Barriers to the Ponseti Method of Clubfoot Treatment in China
No full textIn 2005, a nationwide clubfoot treatment program focused on the Ponseti method -an effective, affordable and minimally-invasive method- was initiated in China. The purpose of this study was to evaluate and identify barriers to the program. A qualitative study (rapid ethnographic study) was conducted using semi-structured interviews of 44 physicians who attended four of the 10 Ponseti training workshops, focus groups with parents of children with clubfoot, and observation. Several barriers to the Ponseti method are quite unique due to China’s size, socio-economics, culture, politics, and healthcare systems. The barriers were classified into seven themes: (i) physician education, (ii) caregiver compliance, (iii) culture, (iv) public awareness, (v) poverty, (vi) financial constraints for physicians/hospitals, and (vii) challenges of the treatment process. A number of suggestions that could be helpful in reducing or eliminating the effects of these barriers were also identified: (i) pamphlets explaining clubfoot and treatment for caregivers, (ii) directories of Ponseti providers, (iii) funding/financial support, and (iv) improving public awareness. The information from this study provides healthcare planners with knowledge to assist in meeting the needs of the population and continued implementation of effective and culturally appropriate awareness and treatment programs for clubfoot throughout China
- …
