None listed
Conditions
Brief summary
The clubfoot (PEVAC) is a development patology, in the anatomopathological study of fetus affected with clubfoot it has been shown that the ligamento Deltoideus, scaphoid-talus and the posterior tibial tendón are very thickened and attached to the calcareis scaphoid plantar ligament. The clubfoot is considered a multifactorial inheritance. The Ponseti method is based on the ability of elongation of collagen fibers present in the pathological ligaments of children with clubfoot, as well as taking into account the biology of the deformity. Dr Ponseti gives special importance to the correction based in the funcional anatomy of the foot The prevalece of this pathology, the serious functional consequences that causes its absence of treatment or incorrect treatment, and the socio-health cost that the management of this type of patient means, makes that this pathology generates special interest. Once the corrective treatment of the deformity is completed and the correction is stabilized, it is considered that the child can perform recurrences of the disease until the age of 3-4 years. Nowadays there is an increasing awareness of the importance of posture in the development of children. In the clubfoot case join the modification of the plantar supports, the load distribution and the size of the affected foot-leg, modifies the position and development of this. There are previous studies that relate baropodometric and stabilometric modificaciones after the global manipulation of the pelvis in healthy subjects, and changes in the extensibility of hamstrings with the same manipulation. Aswell we have found studies that relate the suboccipital inhibition technicque with postural measurements modification, and changes of the extensibility of hamstrings in persons with shortness hamstrings syndrom. In this study we want to evaluate the differences in the plantar supports and in the distribution of load after an global manipulation of the pelvis or after an inhibition of sub occipital musculature. For this we will divide the participants in this study in three groups: First group: Global manipulation of the pelvis. We will seek to improve the mobility of the pelvis. Second group: inhibition of sub occipital musculature. In this case the objective will be to relax the musculature in the cranium-cervical joint. Third group: articular mobilization of the hands. Is the placebo group. The treatment will be performed on one occasion only for 5 minutes. Before and after the treatment we will record the stabilometric and baropodometric data.
Interventions
Group 1: Global Manipulation of the pelvis bilaterally: opening the faces of L5 and sacroiliac joint. Patient in lateral decubitus, in lumbar roll possition. Rotation technique with contact in sacroiliac joint. 1 minute for each manipulation, total time for treatment 2 minutes. Patient will be lying in supine decubitus in the stretcher for 3 minutes. Total time included the time for the treatment are 5 minutes. Duration and frequency of treatment: treatment performed on one occasion only for 5
Group 1: Global Manipulation of the pelvis bilaterally: opening the faces of L5 and sacroiliac joint. Patient in lateral decubitus, in lumbar roll possition. Rotation technique with contact in sacroiliac joint. 1 minute for each manipulation, total time for treatment 2 minutes. Patient will be lying in supine decubitus in the stretcher for 3 minutes. Total time included the time for the treatment are 5 minutes. Duration and frequency of treatment: treatment performed on one occasion only for 5 minutes (total time for treatment is 2 minutes, and lying time is 3 minutes) Group 2: Suboccipital muscle inhibition. Patient lying face up (supine decubitus). therapist sitting with the distal part of the fingers in the suboccipital area, producing a slight ventral and craneal compression. The patient will be 5 minutes in supine decubitus while the treatment will be realized. Frequency and duration: treatment performed on one occasion only for 5 minutes ( total time for treatment and lying time is 5 minutes). In this case the treatment has a duration of 5 minutes, and at the same time, the patient is lying face up. group 3 : Hands Mobilisation. Patient in supine decubitus, therapist sitting by his side. Articulatiry technique for both hands ( two minutes each one). The patient will be 5 minutes in supine decubitus while the therapist realiza the treatment. Frequency and duration: treatment performed on one occasion only for 5 minutes ( 4 minutes lying and treatment and 1 minute just lying face up) Stabilometric and baropodometric measurements pre and post intervention. All the treatment will be administered in a private traumatology clinic, in a room adapted to the physiotherapeutic care of patients, with a stretcher to perform the treatment and a timer to mark the intervention times. The data collection will be performed in a separate room suitable for it. The treatments will be performed by an osteopath with more than 5 years of clinical experience in the field of pediatric osteopathy.
Sponsors
Sandra Balaguer
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver)
Eligibility
Sex/Gender
All
Age
4 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
Uni or bilateral clubfoot treated with Ponseti's method.
Exclusion criteria
Syndromic or neurological clubfoot. Physiotherapic or Osteopathic treatment in the last month. Traumatologic Pathologies in lower extremities or spine in the last month. Pathologies that present with balance alterations in the last month. General Contraindications of the techniques (fractures, severa pathologies, etc...)
Outcome results
None listed