In a study published online April 29 in the Journal of Pediatric Orthopaedics, a team of researchers used a pressure sensor to conclude that caregivers of children who were being treated for clubfoot by the Ponseti Method overreported the amount of time the children used the prescribed orthosis.
The randomized prospective study included 67 children with idiopathic clubfoot who were being treated using the Ponseti Method. Participants, newborn to three years old, were randomized into three groups: a functioning pressure-based sensor (group FPS) attached to the foot abduction orthosis (FAO) (21 patients), a nonfunctioning sensor (NFPS group) attached to the FAO (24 patients), or no sensor (NS group) (22 patients). All caregivers filled out a diary of subjective wear rates. Reported and actual wear rates were recorded as a percentage of the entire day and compared.
In the FPS group, the average actual wear rate for months one, two, and three were 91.7 percent (15 patients ranging from 72.7 percent to 97 percent); 86.8 percent (nine patients ranging from 60.5 percent to 96.3 percent); and 77.1 percent (seven patients ranging from 52.6 percent to 95.8 percent), respectively. In contrast, the average self-reported wear rate in the FPS group in months one, two, and three were 94.9 percent (13 patients ranging from 93.1 percent to 98.7 percent); 95.6 percent (ten patients ranging from 92.3 percent to 99.4 percent); and 94.8 percent (11 patients ranging from 82.8 percent to 99.6 percent), respectively.
The researchers found that the most predictive factor in determining a patient’s decrease in the overall wear rate was a drop in the wear rate between months one and two. The reported wear rates were not statistically different between any of the three groups.
Adherence to FAO wear rates has been postulated to improve treatment outcomes, and the researchers said that their study results puts into question previous assumptions about reported brace compliance.