Clubfoot Research

The Clubfoot Activity & Recurrence Exercise Study (CARES)

What is CARES?

The Clubfoot Activity & Recurrence Exercise Study (CARES) is a prospective cohort study conducted by Dr. Steven Frick at Stanford’s Children Hospital. Clubfoot is a common birth defect, characterized by high arches, an inward curved forefoot, and an inverted heel with a downward pointing ankle. Clubfoot is one of the most common congenital abnormalities, and it affects about 1 in every 1000 children worldwide. Treatment of clubfoot starts within the first two weeks of birth, and it includes two options: the Ponseti method and surgical intervention. Ponseti is the first line for clubfoot treatment, and it involves intermittent stages of foot manipulation followed by periods of casting. Despite being treated, a third of clubfoot patients experience relapse and recurrence of clubfoot. Previous literature shows children with congenital clubfoot who experienced a relapse in treatment function just as well as children who did not experience a relapse. Investigating this claim, this prospective aims at analyzing activity levels in 40 enrolled patients with about a half of the participants categorized as non-relapse controls. Activity levels will be measured via monitoring from a wearable Fitbit device.

How are individuals selected for this study? 

Patients must be between the ages of 5 -10 years old, diagnosed with congenital clubfoot, treated with the Ponseti method for clubfoot correction, and are at least 6 months post clubfoot treatment. Patients’ parents should demonstrate English fluency and literacy and an ability to comprehend and agree to informed consent/assent forms.

Why is this research being conducted?

The purpose of this study is to study activity levels in children with congenital clubfoot. We will investigate whether a relapse in the treatment of congenital clubfoot affects activity levels of children later in life.

Who is conducting this research and where is it being conducted? 

This research is a pilot study being conducted by Dr. Steven Frick and second-year medical student, Ghida El-Banna, at Stanford Children’s Hospital.  

I am interested in learning more, participating in, or have questions about this study. Who can I reach out to?

Please email Danika Baskar at danikab@stanford.edu.

Has recruitment started?

Target enrollment of 30 participants has been completed for the study.

Bracing Compliance in Congenital Clubfoot

What is the focus of this study?

Our team is investigating motivating factors for caregivers of patients with congenital clubfoot that influence compliance with brace wearing guidelines.

How are individuals selected for this study?

Caregivers (i.e. parents, guardians) of individuals diagnosed with congenital clubfoot are eligible to participate.

Why is this study being conducted?

We understand that it can be difficult to consistently comply with brace wearing guidelines for patients with congenital clubfoot. Thus, we are attempting to develop a model that can help motivate caregivers to follow bracing guidelines, and ensure that treatment is as effective as possible.

Who is conducting this research and where is it being conducted?

Dr. John Vorhies from the Department of Orthopaedic Surgery at Stanford University is the Principal Investigator. The study is being conducted at Stanford Children’s Hospital and Clinics.

Has recruitment started?

Recruitment has not yet begun.

I am interested learning more, participating in, or have questions about this study. Who should I contact?  

Please contact Dr. Vorhies’s research coordinator, Joanna Langner at jlangner@stanford.edu with any and all study related questions.

Foot and Ankle Outcomes Assessment Database

Through the Foot and Ankle Outcomes Assessment Database, we hope to study both short and long-term outcomes of treatment and intervention for a variety of pediatric foot and ankle disorders.

Using data gathered from patient reported outcome surveys, pedobarographic data, observational gait analysis, photographs of lower extremities, and physician reports, we are seeking to create a longitudinal database from which outcomes and trends can be analyzed.

This research will allow us to study current clinical practices in the management of pediatric foot/ankle conditions, track progress overtime, and identify potential areas for future investigation.

Delphi Panel on Dynamic Supination in Clubfoot Relapse

The Delphi Panel is a novel research methodology that engages a panel of experts through a series of voting rounds to ultimately present the consensus as achieved by the panel on a topic of interest. Dynamic supination and indications for its treatment are areas that have yet to be studied in reference to clubfoot relapse. By employing the Delphi Panel methodology, we are working on compiling guidance from an international panel of experts in pediatric foot/ankle treatment to best characterize this phenomenon and allow for the development of guidelines for subsequent treatment.

Influence of Social Media on Clubfoot Awareness

With the advent of the social media boom, parents and caregivers have several resources at their fingertips to seek more information and receive guidance from others both in their region and across the globe. This has especially been seen among the Clubfoot community as parents continue to connect with and support one another through several online platforms including Facebook, Instagram, Twitter, and TikTok. Through our research, we are aiming to categorize the types of information being shared and the reach of Clubfoot related content across these mediums.

Conversations Between Parents and their Children about Clubfoot Diagnosis

As treatment for Clubfoot continues into the early years of childhood, our team started this project to explore conversations between parents and their children about sharing a Clubfoot diagnosis and related treatment. Through data gathered from surveys and interviews with parents of affected children, we hope to learn more about how parents share information and educate their child about a clubfoot diagnosis and treatment across various age groups. The information learned will also help our team provide a framework for parents who are seeking guidance in navigating these conversations based on a child's age and level of understanding.