Up next in the “interview with an expert” series is the second part with Orsolya Türei, professional physiotherapist. She will provide further info about the Dévény method (DSGM SMT) which complements the Ponseti clubfoot treatment.
Because of the topics complexity this interview will be split into 4 parts. You can find the first part here.
What makes the Dévény method stand out when treating clubfoot patients?
„Look at what everyone is looking at, and see what no one else has seen.” Thomas W. Myers
This quote represents the secret to the Ponseti method’s and the Dévény technique’s success and unique effectiveness. To understand determining connections we need to look at the human body at its complexity, while putting its functionality in the forefront. These connections remain hidden for therapies that only focus on a specific part of the body. This nature of experiencing helps recognise and observe the
functional pathomechanism, which forms the backbone of my thesis too.
When should the Dévény treatment be started in case of clubfoot?
The DSGM therapy should ideally start at the same time when the patient starts wearing the boots and bar (in certain cases it is possible to start during the casting period, while this is really good, it is not a problem if it is not happening). If we consider the phases of the Ponseti-treatment, the 23 hour bracing period starts at the time when voluntary movements of the gross motor skills start to appear. (3-3.5 months – this is a very sensitive period for the development of the central nervous system)
Based on the above, this is the minimum recommendation for seeking the help of a DSGM therapist:
1. Structural correction – after the casting period (3-5 months)
Task: restoring congenital or acquired muscle imbalance, maintaining mobility while correcting the structure.
2. Developmental stages of the lower limbs – partial and full load (8-10 months)
Task: standing up straight, standing, securing the side steps motion pattern, in case of unilateral clubfoot establishment of the median line of the body weight.
3. Unassisted standing and walking appears (12-18 months)
Task: ensuring the ability to achieve a harmonious and efficient motion pattern (mobility, muscle strength, mechanical axis of the lower limbs). Observing structure and function in context of cause and effect. Aim: correct walking pattern. In case of need footwear advice.
4. Monitoring every 6-12 months (until the appearance of the regular running pattern – 2.5-3 years)
Task: quality control of dynamic motion
5. Parental education: positioning, passive adjustments, tendon mobility. Teaching of active exercises based on age.
In the third part of our interview series Orsolya will tell us: when our child can become an active part of the treatments, or when a physiotherapist would consider a clubfoot patient “healed”.
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