Effectiveness of Home Stretching Exercise for the Treatment of Congenital Talipes Calcaneovalgus: A Randomized Controlled Trial
Kaewpornsawan K, MD1, Sookwanich P, MD2, Eamsobhana P, MD1, Ariyawatkul T, MD1, Wongcharoenwatana J, MD1, Udompunturak S, MSc3
Affiliation : 1 Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Department of Orthopaedic Surgery, Faculty of Medicine, HRH Princess Maha Chakri Siridhorn Medical Center (MSMC), Nakhon Nayok, Thailand 3 Division of Clinical Epidemiology, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Congenital talipes calcaneovalgus (CTCV) is the deformities characterized by hyperdorsiflexion of the foot against the
anterior surface of the tibia. The treatments proposed were gentle stretching exercises performed by the parents, corrective casting
or splinting with or without stretching exercises. No information regarding effectiveness of the treatment or comparing the outcome
between the treatments.
Objective : The purpose of this prospective randomized controlled study is to evaluate the effectiveness of stretching manipulation
performed by the parents, in comparison with no treatment, in newborns with congenital talipes calcaneovalgus (CTCV).
Materials and Methods : The healthy babies aged ranging from 1 to 7 days, who were born with CTCV were included in the present
study. Simple randomization was done to allocate the patients into 2 groups. In group A-the treated group, the parents were taught
to perform stretching exercise consisting of passive plantar flexion of the deformed foot for at least 10 seconds each time and at least
10 times a day. Group B contained the newborns that did not receive any treatment other than explanation about diagnosis, prognosis
and follow-up plan. The follow-up intervals for both groups were one, three, four, six and ten months after enrollment. The
demographic data in sex, affected side, severity of the deformity, weight and height of the newborns were recorded. The outcome
measured included rate and time to recovery for each group.
Results : There were 38 cases (16 boys, 22 girls) in group A and 36 cases (15 boys, 22 girls) in group B who had complete follow-
up data for the final analysis. There were no statistically significant differences in sex, affected side, severity of the deformity, weight,
height, recovery time, and success rate between the two groups.
Conclusion : The foot with uncomplicated CTCV have good prognosis and achieve full recovery within 300 days regardless of
treatment.
Keywords : Effectiveness, Stretching exercise, Newborns, Congenital talipes calcaneovalgus, Randomized controlled trial
