Munambah N, Chiwaridzo M, Mapingure T
Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare Zimbabwe.
SANDI Rehabilitation, Lilongwe, Malawi.
Arch Physiother. 2016 Jun 30;6:7. doi: 10.1186/s40945-016-0021-5. eCollection 2016.
The Ponseti method of managing clubfoot was introduced in Zimbabwe in 2011. This followed massive training of health workers such as medical rehabilitation practitioners through a programme called the Zimbabwe Sustainable Clubfoot Programme. Today, the Ponseti method is the technique of choice for managing clubfoot in hospitals. However, since then, there is no published evidence documenting the efficacy and the relevance of the technique especially comparing to previously used methods. This is a significant shortcoming if sustainability issues are to be considered. Therefore, this study was designed to investigate the impressions and opinions of medical rehabilitation practitioners on the method in terms of its effectiveness, perceived challenges and possible recommendations for improvement of the technique application in their setting.
A descriptive cross-sectional study was conducted targeting medical rehabilitation practitioners previously trained on the method and working in public or private clinics that offer clubfoot management in Harare. A questionnaire was self-administered to 41 participants who volunteered to participate in the study. Data from open-ended questions was analysed thematically. Statistica version 12 was used for analysis for quantitative data.
The Ponseti method was perceived as an effective method in the treatment of children with clubfoot by all the participants. All the participants 41 (100 %) felt that the method was relevant because of better clinical outcomes. Amongst challenges faced when using Ponseti method, 25 (61 %) participants agreed that caregivers to the children with clubfoot were not compliant to treatment. A total of 22 (54 %) participants felt that lack of adequate insight by the caregivers of this new method was a challenge which hinder progress in treating clubfoot.
The medical rehabilitation professionals in Harare, Zimbabwe trained to use the Ponseti technique for the management of clubfoot, perceived the method as an effective method resulting in better clinical outcome than previous methods. This probably highlights the need to continue training medical rehabilitation professionals so that there is widespread use of the technique in the country. However, there is need to increase awareness of the method among caregivers to improve compliance, which is key to successful rehabilitation of the clubfoot.
庞塞蒂方法于2011年引入津巴布韦用于治疗马蹄内翻足。在此之前，通过一个名为津巴布韦可持续马蹄内翻足项目，对包括医学康复从业者在内的卫生工作者进行了大规模培训。如今，庞塞蒂方法是医院治疗马蹄内翻足的首选技术。然而，自那时以来，尚无已发表的证据记录该技术的疗效及相关性，尤其是与先前使用的方法相比。如果要考虑可持续性问题，这是一个重大缺陷。因此，本研究旨在调查医学康复从业者对该方法在其所在环境中的有效性、感知到的挑战以及改进技术应用的可能建议方面的印象和看法。
针对曾接受过该方法培训且在哈拉雷提供马蹄内翻足治疗的公立或私立诊所工作的医学康复从业者，开展了一项描述性横断面研究。向41名自愿参与研究的参与者自行发放问卷。对开放式问题的数据进行主题分析。使用Statistica 12版本对定量数据进行分析。
所有参与者都认为庞塞蒂方法是治疗马蹄内翻足患儿的有效方法。所有41名（100%）参与者都认为该方法具有相关性，因为其临床效果更好。在使用庞塞蒂方法时面临的挑战中，25名（61%）参与者一致认为马蹄内翻足患儿的照料者不配合治疗。共有22名（54%）参与者认为照料者对这种新方法缺乏足够的了解是阻碍马蹄内翻足治疗进展的一个挑战。
在津巴布韦哈拉雷接受过使用庞塞蒂技术治疗马蹄内翻足培训的医学康复专业人员认为，该方法是一种有效的方法，其临床效果优于先前的方法。这可能凸显了继续培训医学康复专业人员的必要性，以便该技术在该国得到广泛应用。然而，需要提高照料者对该方法的认识以提高依从性，这是马蹄内翻足成功康复的关键。
