Forefoot Adduction (FFA) in Infants and Toddlers. Differences of Neuromuscular Activity.

Difference of Neuromuscular Activity in Infants and Toddlers With Foot Dorsiflexion Compare to Infants and Toddlers With Foot Plantarflexion

Every week we encounter with 5-8 pairs of worried parents of infants with forefoot adduction. Most of them usually need only reassurance and education how to manipulate the deformed foot. During the examination we usually use provocative maneuver to trigger peroneal activity. This manual stimulation usually reveals active eversion and dorsiflexion of the foot in most of the children, but not in all of them. Small part of the children reacts in opposite direction - instead of the typical eversion they demonstrate inversion and some plantar flexion of the foot. We have the impression that this subgroup of children improves the deformity slower and sometime less complete than most of the children. We did not find in the literature any description of this phenomenon. We postulate, that atypically reacting patients probably have different response due to abnormalities of neuromuscular balance between invertors-flexors and evertors-extensors muscle groups. This small subgroup of children may need more close follow-up and probably casting to speed up and secure the improvement of their deformity.

Study goals:

1. Evaluate ability of children with FFA to respond on mechanical triggering of peroneal activity

   1. The majority of the patients with standard reaction - foot dorsiflexion and eversion (evertors)
   2. The minority of the patients with nonstandard reaction - foot plantarflexion and inversion (invertors)
2. Evaluate randomly selected children from each group for character of muscular response on electrical stimulation (EMG) of calf muscles.

Study Overview

• Status: Suspended
• Conditions: Forefoot Adduction
• Intervention / Treatment: Other: mechanical triggering of peroneal activity

• Study Type: Observational
• Enrollment (Anticipated): 20

Contacts and Locations

Study Locations

• Israel
  • Jerusalem, Israel
    • Hadassah Medical Organization.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 2 months to 1 year (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

infants and toddlers with Forefoot adduction

Description

Inclusion Criteria:

1. Boys and girls between two months and one year old.
2. Non associated pathology.
3. Signing Informed consent.

Exclusion Criteria:

1. Unwillingness to sign informed consent.
2. Associated pathology

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
evertors, invertors	Other: mechanical triggering of peroneal activity; mechanical triggering of peroneal activity

Collaborators and Investigators

• Sponsor: Hadassah Medical Organization
• Investigators: Principal Investigator: Naum Simanovski, MD, Hadassah Medical Organization

Study record dates

Study Major Dates

• Study Start: March 1, 2008
• Primary Completion (Anticipated): March 1, 2012

Study Registration Dates

• First Submitted: May 6, 2007
• First Submitted That Met QC Criteria: May 6, 2007
• First Posted (Estimate): May 8, 2007

Study Record Updates

• Last Update Posted (Estimate): May 12, 2011
• Last Update Submitted That Met QC Criteria: May 11, 2011
• Last Verified: April 1, 2011

More Information

Terms related to this study

• Other Study ID Numbers: SIM03-HMO-CTILL