Centrally adaptations in unilateral idiopathic clubfoot children following conservative treatment.

Adaptations in tiptoe rising were studied in unilateral idiopathic clubfoot (ICF) children, who underwent conservative treatment. The current study concerned 10 ICF children and 10 healthy children of the same range of ages (8-12 year). All ICF children were rated "good" or "very good" treatment results, but showed residual m. Triceps surae atrophy and mild foot alignment flaws. Tiptoe rising task was performed with subjects standing quietly with the feet on separate force platforms. Subjects were instructed to rise onto tiptoes as fast as possible and to maintain the tiptoe erect posture for a few seconds. Surface EMG of muscles Gastrocnemius, Tibialis anterior, Peroneus longus were recorded on both sides, simultaneously with vertical reaction forces (RZ) and centres of pressure (CP) displacements, during a series of 10-15 trials. Foot preferentiality was without influence on the EMG and biomechanical activities of the control group. Although not aware of a deficit in performance, ICF children show less vertical acceleration than healthy children. Timing and magnitude of muscular activities, and Cp and RZ variables of ICF children, evidenced alterations in both affected and sound side, when compared to healthy subjects. Alterations in the affected side activities were well explained by Triceps surae atrophy. Alterations in the sound side were considered as adaptations of central nervous system (CNS), preserving a global symmetry of the task. These results highlight the CNS capacity to adapt even for mild deficiencies. They stressed that it is mandatory to follow ICF children, even if they recovered a normal life.