Up next in the “interview with an expert” series is the final, fourth 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 has been split into 4 parts. You can find the first part here, the second part here and the third part here.
The topic of your MSc thesis on SOTE-ETK was the treatment of babies born with clubfoot. Can you please share the focus and conlusions of your research?
The focus was the scientific studies from the last 10-15 years that compared the results of conservative vs. surgical treatments and the comparison of various conservative treatment types. (Zapata and Co, 2018; Sala and Co, 2013; Karol and Co, 2016). The professionals performing the examinations prefer the conservative treatments vs. the surgical ones. (Zapata and Co, 2018). The comparison between the French functional method, which involves no surgery and the Ponseti method, which has minimal surgical intervention show that the children treated with the Ponseti method come closer to the normal physiological range of joint movement, while the children treated with the French functional therapy surpass those treated with the Ponseti method when it comes to the quality and development of their gross
motor skills and gross motor function (GMS and GMF) (Karol and Co, 2016). The most important note for us (physiotherapists) is that the Ponseti method is an excellent way to correct the deformed structure of the foot, but it doesn’t help sufficiently with the body’s complete gross motor functions. The studies do not focus on measuring the development of the gross motor functions, as a result it is not apparent for
them that the distortion of the kinetic system of the lower limbs (the coherent functional connection of the joints of the lower limbs) exists already in the beginning of the development of the motor skill patterns (onthogenesis of the motorium). Meaning out of an incorrect set of motor skills only incorrect motion patterns can result. (crawling, sitting – W shaped sitting) The French treatment identifies the problem of the difference in quality of the motor skills of children with clubfoot and those treated with the French method. (Zapata, Karol and Co, 2018; Karol and Co, 2016) The studies highlight this problem, but they do not provide any recommendations for resolving this.
My thesis however presumes that the Dévény method supplementing the Ponseti therapy could provide a solution and treat the recognised issues in the incorrect motion patterns. Unfortunately human motion development by repetition of motion patterns alone cannot resolve the issues that are a result of the Ponseti treatment. This can only be achieved by a therapy that affects all elements of the joints structure and is able to be an active part of the development of the motor skills. The Dévény method meets these expectations. This manual technique isn’t handling muscles on their own, but as part of a functional and anatomical system. It is applied along the bodies connective tissue grid (fascia) and musculoskeletal system, it is implemented along the stations of movement development, it is static and is carried out with either active or passive mobilisation. By using the Dévény method the consequence of the one-sided static load (resulting from casting and the abduction brace) and the impact it has on the motion patterns of infants and children can be reduced thus ensuring the development and timely appearance of the correct motor skill patterns.
What does the Hungarian parental support group and its community mean to you? (Dongaláb…., azaz, azok a csodás lábikók..)
This group is a perfect example of a self organised support group, it is a genuine and supportive community who just love to help the fellow parents who are in the same situation. Everyone can draw power and inspiration from this group, those who are at the beginning of the road and those who are halfway through but have hit a slight bump on their journey as well. I always recommend this group from the bottom of my heart whenever I encounter parents during my line of work.
I would like to say thank you to Orsolya Türei one more time for being available and sharing her thoughts with us. I really hope you found our interview series useful.
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