Dennis Assibey¹& Rami J. Abboud²

1Department of Physiotherapy and Rehabilitation, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana

2Institute of Motion Analysis & Research (IMAR), University of Dundee, TORT Centre, Ninewells Hospital & Medical School, Dundee DD1 9SY, Scotland, UK

Dennis Assibey, PT., M.Sc.

E-mail: dassibey@uhas.edu.gh

Background: Clubfoot (Congenital talipes equinovarus, CTEV) is a congenital deformity of the foot where the hindfoot is in equinus and varus deformity, midfoot in cavus, and forefoot adducted. Recurrence after clubfoot treatment is common and can cause pain in the foot as well as walking difficulty. Biomechanical assessment is vital in clubfoot assessment to detect foot alterations that can cause a relapse.

Objective: To design a device to assess the relapse or over-correction of clubfoot in children aged 1 to 8 years.

Methods: The device (Assibey-Abboud Clubfoot Assessment Device) was designed based on a clubfoot pictorial scale developed by the Institute of Motion Analysis and Research (IMAR) at the University of Dundee in Scotland. It was used to assess 30 podotrack (PDT) footprints by two raters and their diagnoses were compared to a highly valid diagnosis from a bean shape ratio (BSR) values obtained from same footprints in a previous clubfoot study.

Results: Intraclass correlation coefficient (ICC) value >0.7 for intra-rater reliability and ICC of > 0.7 (kappa value 0.856) for inter-rater reliability between the two raters and the BSR. The qualifiers of ICC and kappa indicate that intra-rater and inter-rater reliability were good. The device provided good repeated assessment.

Conclusion: The device yielded replicable results and may be helpful in assessing recurrence of clubfoot deformity among children aged 1 to 8. The use of the Assibey-Abboud Clubfoot Assessment Device may also enhance clinical decision-making.

Keywords: Clubfoot, recurrence, intraclass correlation coefficient, intra-rater reliability, inter-rater reliability

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2. Ponset IV (2008). Congenital clubfoot: Fundamentals of treatment. 2^nd Ed. Oxford University Press, New York ISBN 0 19 262765 1 (h\b)
3. Ramanathan AK, Abboud RJ (2010). Clubfoot assessment: the complete IMAR footprint. Orthop Trauma; 24(4): 303-38