Compliance with continuous passive movement is low after surgical treatment of idiopathic club foot in infants

Abstract

Treatment by continuous passive movement at home is an alternative to immobilisation in a cast after surgery for club foot. Compliance with the recommended treatment, of at least four hours daily, is unknown. The duration of treatment was measured in 24 of 27 consecutive children with a mean age of 24 months (5 to 75) following posteromedial release for idiopathic club foot. Only 21% (5) of the children used the continuous passive movement machine as recommended. The mean duration of treatment at home each day was 126 minutes (11 to 496). The mean range of movement for plantar flexion improved from 15.2 degrees (10.0 degrees to 20.6 degrees ) to 18.7 degrees (10.0 degrees to 33.0 degrees ) and for dorsiflexion from 12.3 degrees (7.4 degrees to 19.4 degrees ) to 18.9 degrees (10.0 degrees to 24.1 degrees ) (both, p = 0.0001) when the first third of therapy was compared with the last third. A low level of patient compliance must be considered when the outcome after treatment at home is interpreted.