Prevalence of Spastic Cerebral Palsy in Children with Congenital Talipes Equinovarus and Its Association with Ankle Foot Functional Performance
DOI:
https://doi.org/10.61919/620tpe37Keywords:
Congenital Talipes Equinovarus; Cerebral Palsy; Spastic Diplegia; GMFCS; Modified Ashworth Scale; Foot and Ankle Disability Index; Orthoses.Abstract
Background: Congenital talipes equinovarus (CTEV) frequently co-occurs with neuromotor disorders such as spastic cerebral palsy (CP), yet the relative contributions of static deformity versus neuromotor severity to ankle-foot function remain unclear. Objective: To determine the burden of spastic CP among children with CTEV and examine the association between neuromotor severity and ankle-foot functional performance. Methods: In an analytic cross-sectional study at tertiary rehabilitation/orthopedic clinics in Faisalabad over 10 months, consecutive children aged 5-15 years with CTEV underwent standardized assessments: CP subtype, Gross Motor Function Classification System (GMFCS), spasticity via Modified Ashworth Scale (MAS), CTEV severity via Pirani components, and ankle-foot function via the Foot and Ankle Disability Index (FADI). Primary outcomes were spastic CP burden and FADI; secondary analyses tested associations using χ²/t tests and regression adjusted for age, sex, bilaterality, and orthosis use (α=0.05). Results: Of 104 participants (mean age 6.95±2.80 years; 51% female), spastic CP was predominantly diplegic (81.7%), with bilateral CTEV in 90.4% and high rates of rigid equinus (left 92.3%, right 97.1% moderate/severe). Severe functional disability was common (FADI <40 in 76.0%). CP subtype strongly associated with functional disability (Cramer’s V 0.970; p<0.001), whereas structure-function correlations were weak (Spearman ρ −0.133; p=0.179). Adjusted models identified GMFCS and MAS as principal determinants of FADI. Conclusion: In CTEV, ankle-foot function is driven more by neuromotor severity than by static deformity; management should prioritize neuromotor-informed, function-focused programs integrating spasticity control, task-oriented training, and orthotic optimization.
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