Neurodevelopmental difficulties in children with idiopathic clubfoot

Abstract

A substantial minority of children with idiopathic clubfoot show neurodevelopmental difficulties. Children with idiopathic clubfoot might present additional difficulties in motor skills, perception, and language. Children with idiopathic clubfoot and marked neurodevelopmental symptoms show poorer parent-reported clubfoot treatment satisfaction. Neurodevelopmental difficulties should be considered in clinical practice of idiopathic clubfoot.

Neurodevelopmental difficulties negatively affect health‐related quality of life in children with idiopathic clubfoot

“…Sex and clubfoot laterality did not affect HRQoL. However, the coexistence of NDD appearing in IC above chance significantly decreased HRQoL. The observation that 41% of the children with IC reported pain or discomfort is alarming and indicates that the general treatment goal of a pain‐free foot is not being achieved in a large proportion of the affected children.…”

“…Accordingly, the 90th percentile for any domain score has been defined as a cut‐off for potential clinical concerns . The Five to Fifteen questionnaire has demonstrated acceptable to excellent interrater and retest reliability and has previously been used to screen for NDD in children with IC . It was used in this study to classify children with IC into those with and without NDD.…”

“…However, since the domain motor skills might be affected of the clubfoot, we defined two or more domains above the 90th percentile to be relevant, in relation to the distribution of the general population sample. Detailed information of the NDD definition within IC can be found elsewhere .…”

“…Although IC traditionally is considered an isolated deformity, co‐occurrence of neurodevelopmental difficulties (NDD) has been found in as many as one‐third of children with IC . Moreover, parents of children with IC and coexisting NDD have reported less satisfying clubfoot treatment outcome . These findings suggest some yet unknown connection between the musculoskeletal deformity and NDD.…”

Non‐motor difficulties in children with idiopathic clubfoot: can this impact brace adherence?

“…The study by Lööf et al . is the first which shows these differences and is predicated on their prior work which revealed that motor skills in children with idiopathic clubfoot were affected by factors other than musculoskeletal deficiencies.…”