SPECIAL INTEREST REPORT POSTER DISPLAY

PHYSICAL THERAPY AND ORTHOPEDIC TREATMENT FOR CONGENITAL FOOT DEFORMATIONS IN THE SIX FIRST MONTHS OF LIVE. Andre Vert J; Haute Autorité de santé (French National Authority of Health), Saint-Denis, France

PURPOSE: French National Authority of Health elaborates clinical guidelines on the management of the different foot congenital deformities by physiotherapists and orthopedic surgeons from birth to 6 months. These guidelines should answer to diagnostic and referral to specialist, watch over or treatment, type of treatment (manual therapy, orthetic, plaster or mixed) and type of information and education for parents. RELEVANCE: French national employed PT association stated by survey how prescription and physical therapy pratice and involvement were very different from a maternity hospital to another. Congenital foot deformities in France concern more than 20 000 new borns a year. A professionnal consensus was necessary to optimize quality of management for foot deformities. DESCRIPTION: A systematic review of the literature was conducted and scientific report written on physical examination, medical decision making and physical therapy and orthopedic treatment. A 18 pluriprofessionnal experts panel from different parts of France and from different facilities discussed this report to elaborate recommendations. These were graded by an external group of 60 professionnals before implementation. EVALUATION: On 247 analysed articles, only 2 proposed validated clinical scores of gravity, 38 were cohort studies based on heterogeneous clinical critria, and no RCT’s were identified up to 2004. So recommendations are principally based on professionnal agreement. CONCLUSIONS: Recommandations are made to use a single validated clinical score to be able to compare the differents treatments during the first year of live. Future research should develop clinical studies to better understand pronostic factors and compare the differents manual, orthotic and plaster techniques. IMPLICATIONS: These guidelines provide clinical examination charts and algorythm that allow professionnal to easily select audit criteria for quality improvement program as required in our accreditation manual for health care organisations. KEYWORDS: Clinical Guidelines; Foot deformities, congenital; Infant, new born. FUNDING ACKNOWLEDGEMENTS: This work was entirely supported by the French National Authority for Health. CONTACT: j.andrevert@has-sante.fr