THE EFFICIENCY OF KINEZITHERAPY IN THE TREATMENT OF THE CLUBFOOT TILL THE SURGICAL PERIOD. SUMMARY Clubfoot – is one of the common congenital deformation of skeleton-muscular system, wich requires active treatment. It is one of the most frequent reasons for phisical incapability. The incidence of clubfoot is approximately 1-2 cases per 1000 live births in the world, and 2 cases per 1000 – in Lithuania. 80 % of those cases are diagnosed in less economically developed countries. The problem is relevant because investigators present different outcomes of treatment. We couldn’t find any articles about kinezitherapy treating this deformation. The aim of the objective was to evaluate the efficiency of kinezitherapy in the treatment of clubfoot till the surgical period. In order to achieve this object the following tasks were set: To compare the function of the foot before and after kinezitherapy correction. To identify parients opinions about the changes of the function of the foot. To identify medical opinion about the changes of the function of the foot till the surgical period. Investigation included 8 children with clubfoot deformity before eight months of age. The function of foot was evaluated by thr method of goniometry. Also, the qualitive research was done by the method of phenomenography. In the qualitive research 3 parients of children and one doctor were included. After analysis done by mathematical statistics method the folowing conclution was done: After kinezitherapy... [to full text]

The overall aim of this thesis on congenital clubfoot was to estimate the incidence with a national perspective, analyse residual deformities and their management, and evaluate patient reported long-term quality of life and foot function. Paper I was a prospective, nationwide sampling of 280 children with congenital clubfoot during 1995-96. The average incidence was 1.4‰. There was regional heterogeneity but no seasonal variation. Paper II evaluated ultrasonography on 54 newborn, prospectively followed up to 12 months of age. Significant increase of medial malleolus to navicular distance (MM-N-distance) and of soft tissue thickness with increasing age was seen and with acceptable reliability. Paper III assessed 35 children (47 feet) after previous posterior release, mean age of 4.5 years, and the MM-N-distance was shorter in unilateral clubfeet (21 patients) than in contralateral normal feet. No association between navicular position and forefoot adduction (FFA) was determined. Smaller FFA yielded better subjective and functional outcome. Paper IV reviewed distraction treatment with Ilizarov External Fixator in seven patients (10 feet), 6-15 years of age, with relapsed deformities. All patients, except one, reported satisfaction with the overall result but less stiffness was experienced in only 4/10 feet. Paper V evaluated self-estimated outcome in 83 patients (63 males, 20 females), mean age of 64 years, through SF-36 and EQ-5D, and through AAOS foot and ankle score. Age and gender adjusted norm groups were used. Female patients scored worse than male patients did. Both males and females reported negative influence on foot and ankle function. Conclusion: The incidence of congenital clubfoot in Sweden is higher than in previous Scandinavian studies. Ultrasonography is reliable for describing pathoanatomy of the talo-navicular joint in clubfeet and can detect "spurious" (false) correction. Distraction treatment with the Ilizarov External Fixator yields subjective improvement but stiffness remains. Long-term influence on daily life activities is limited to foot and ankle function for both genders, but only female patients report negative influence on physical aspects of quality of life.

The area of the care of a Clubfoot (pes equinovarus congenitus PEC Clubfoot) Diagnosed Child is the topic of this Paper. Currently, the PEC is the second most frequent congenital deformity within orthopaedics. The theoretical part of this Paper deals with a description of the PEC, its diagnostics, cure and a possible risk of relapse. A sub-chapter of the Paper introduces the Achilleus association, which is the only body in the Czech Republic bringing together parents of PEC diagnosed children. The Paper also focuses on nurses and their role(s) in the nursing care of PEC diagnosed children. The empirical part of this Paper covers a research with the following directions: - parental knowledge of PEC diagnosed children care at home; - specifications of the nursing care of PEC diagnosed children; - nurses and their educational role (if fulfilled) in the nursing care of PEC diagnosed children. The research presented in the empirical part of the Paper was based on a semi-structuralized interview and open coding technique. The interviews were conducted with parents of PEC diagnosed children and care providing nurses who also play an important educational role in this matter. The benefit of the Paper, based on collected research data, is to provide a complete overview on the problems relating to the care of PEC diagnosed children. The outcome is supposed to be also presented to appropriate expert public for further consideration. The research outcome presents that the level of parental knowledge of the PEC diagnosed children care at home is very high and that parents provide their children with a quality care. The Paper describes that specifications of the nursing care of PEC diagnosed children are mainly evident in appropriate and consistent education of parents as the homecare is usually a long-term process. Finally, the Paper also shows that nurses in their educational role in the nursing care of PEC diagnosed children do not fulfil their tasks to such an extent that is expected.