Standing and walking age in children with idiopathic clubfoot: French physiotherapy versus Ponseti method.

PURPOSE: A mild delay in gross motor milestones and walking age has been reported in infants with clubfoot. The influence of different treatments on motor development has been poorly investigated. Some parents and physical therapists express concern that the Ponseti method (PM) and its constraints (abduction brace, casts) would affect development more than the French physical therapy method (FM) due to greater immobilization and lesser stimulation.The purpose of this study was to evaluate achievement of three motor milestones (pull-to-standing, cruising and independent walking) in two groups of clubfoot patients treated at two experienced institutes respectively with the PM and FM. METHODS: In all, 52 consecutive infants (full-term at birth, mean age at beginning of treatment 24.3 days (sd 10), mean Dimeglio score 12 (sd 3.4)) were prospectively enrolled (26 patients per centre) and followed up to walking age recording milestones. RESULTS: The two groups were not different in terms of age at the beginning of treatment (p = 0.067) and rate of tenotomy. Age at tenotomy was significantly lower in the PM group (p = 0.000). Severity (p = 0.004) and number of bilateral cases (p = 0.012) were higher in the PM group. A non-significant difference was found for age of achievement of pull-to-standing (p = 0.109), cruising (p = 0.253) and independent ambulation (p = 0.349) between the two groups. Overall, milestones were achieved approximately two months later than normal population. Sex, severity, laterality and need of tenotomy were not found to significantly influence milestones. CONCLUSION: Our results confirmed that infants with clubfoot are expected to have a minimum delay in motor development. Infants treated with the PM and those treated with the FM did not show significant differences in gross motor milestones achievement at walking age. LEVEL OF EVIDENCE: Level II - Prospective comparative therapeutic studies.

As monografias da escola de educação física do Espírito Santo: circulação e produção de saberes (1932-1939) / The monographs from the Espírito Santo school of physical education: knowledge circulation and production (1932-1939) / Las monografías de la escuela de educación física de Espírito Santo: circulación y producción de conocimientos (1932-1939)

Analisa o processo de elaboração de monografias na Escola de Educação Física do Espírito Santo para compreender a formação de professores, a circulação de saberes e sua materialização como dispositivo de controle dos conhecimentos incorporados. Utiliza como fontes os documentos presentes no Arquivo Permanente do Centro de Educação Física e Desportos da Universidade Federal do Espírito Santo, entre os anos de 1932 e 1939. Usa como referencial teórico e metodológico os conceitos de lutas de representações e circulação e o modelo do paradigma indiciário. Os indícios nos permitem compreender que as monografias eram um dispositivo que reforçava a utilização do Método Francês.Os alunos usaram os recursos disponíveis na escola, como livros e periódicos, para sua elaboração. Os temas presentes nos trabalhos referiam-se aos saberes apresentados para a formação dos professores e à forma como o Método Francês foi utilizado no Estado

This article examines the process of writing monographs at the Espírito Santo School of Physical Education to understand teacher training, knowledge circulation and its materialization as a device to control incorporated knowledge. As sources, it uses documents in the Permanent Archive of the Center for Physical Education and Sports of the Federal University of Espírito Santo between 1932 and 1939. Its theoretical and methodological framework are the concepts of representational struggles, circulation and the model of the index paradigm. The evidence allows us to understand that monographs reinforced the use of the French Method. To write them, students used resources available at the School such as books and journals. The works' topics were related to knowledge presented for teacher training and the way the French Method was used in the state

Analizar el proceso de elaboración de monografías en la Escuela de Educación Física de Espírito Santo para entender la formación del profesorado, la circulación de conocimientos y su materialización como dispositivo de control de los conocimientos incorporados. Utiliza como fuentes los documentos presentes en el Archivo Permanente del Centro de Educación Física y Deportes de la Universidad Federal de Espírito Santo, abarcando el periodo entre 1932 y 1939. Utiliza como referencia teórica y metodológica los conceptos de lucha de representaciones y circulación y el modelo del paradigma indiciario. Los indicios nos permiten comprender que las monografías eran un dispositivo que reforzaba la utilización del Método Francés. Los alumnos utilizaron los recursos disponibles en la escuela, como libros y revistas, para su elaboración. Los temas presentes en el trabajo se referían a los conocimientos presentados para la formación de los profesores y a la forma en que el Método Francés ha sido utilizado en Espírito Santo

Comparison of different conservative treatments for idiopathic clubfoot: Ponseti's versus non-Ponseti's methods.

Objective Various methods are applied in the clinical treatment of idiopathic clubfoot. The purpose of this meta-analysis was to evaluate the efficacy of different conservative treatments. Methods Studies were pooled and odds ratio (ORs) with corresponding confidence intervals were calculated for evaluation of the results, relapses, and requirement for major surgery. Results A final analysis of 1435 patients from 9 eligible studies was performed. The combined OR indicated that significantly more fair and poor results were achieved and that major surgery was required significantly more often when using non-Ponseti's methods (OR = 3.33 and OR = 7.32, respectively), but no significant difference was detected in the occurrence of relapse (OR = 1.34). Pooled OR evaluation showed a significantly higher rate of fair and poor results, relapse, and requirement for major surgery when using Kite's method than when using Ponseti's method (OR = 3.93, OR = 2.53, and OR = 3.19, respectively), but no significant difference was detected between the French method and Ponseti's method (OR = 3.01, OR = 0.72, and OR = 1.26, respectively). Conclusions This meta-analysis indicates that Ponseti's method is safe and efficient for conservative treatment of clubfoot and decreases the number of surgical interventions required. It is recommended as the first-choice conservative treatment for idiopathic clubfoot.