Effect of physiotherapy on number of casts in treatment of congenital talipes equinovarus (Club Foot).

Objective: To evaluate the effectiveness of pre-casting physiotherapy in reducing the number of casts required for correction in congenital talipes equinovarus (CTEV) using the Ponseti method. Study Design: Prospective, Interventional Trial. Setting: Orthopedic Outpatient Department, Jinnah Postgraduate Medical Centre, Karachi. Period: January 2024 to June 2024). Methods: A total of 102 patients with idiopathic CTEV were recruited and divided into two groups: Physiotherapy group (n=51): Received pre-casting physiotherapy followed by standard Ponseti casting. Control group (n=51): Underwent standard Ponseti casting without physiotherapy. The primary outcome was the number of casts required for correction, while secondary outcomes included final correction rates, compliance, and relapse rates. Results: The physiotherapy group required significantly fewer casts for correction compared to the control group (mean: 4.3 vs. 5.8 casts, p = 0.005). Both groups achieved a similar final correction rate of 88.2% (p = 1.000). Compliance was higher in the physiotherapy group, with 78.4% showing excellent adherence compared to 51% in the control group, (p = 0.002). Relapse rates were lower in the physiotherapy group (7.8%) than in the control group (13.7%), but this difference did not reach statistical significance (p = 0.338). Conclusion: Pre-casting physiotherapy significantly reduces the number of casts required for correction in the Ponseti method, potentially improving patient compliance and reducing treatment burden without compromising final correction outcomes. These findings suggest that physiotherapy may be a valuable adjunct in optimizing CTEV management. Further randomized controlled trials are recommended to validate these findings.