Managing Children with Clubfoot

This course took place a free open online course in 2017. The course has since been updated and accredited for CEUs/CPD points and is available for you to do at any time in Physioplus, it can be started and completed at any time that suits you. It is also available in French.

Summary[edit | edit source]

  • Course Type- Online
  • Course Co-ordinators - Rachael Lowe
  • Institution - ICRC and Physiopedia
  • About this course - This online course will develop knowledge of clubfoot management.
  • Who can take part- This course is aimed at Physiotherapy and Physical Therapy professionals, clinicians, students and assistants; other interested health care professionals interested in this subject are more than welcome to participate.
  • Date of next course - This course ran as a MOOC in Nov 2017, it remains available on Physioplus.
  • Time commitment - approximately 16 hours over 4 weeks
  • Language - the is an English and French version of the course
  • Requirements - You will complete online learning activities, engage with additional resources, take part in the conversation online and complete the course evaluation.
  • Assessment - There will be a final quiz.
  • Awards - 16 PP+ points will be awarded on completion of this course (an additional 2 PP+ points available on completion of an optional assignment).

Introduction[edit | edit source]

In 2017 Physiopedia and the International Committee of the Red Cross (ICRC) and the Global Clubfoot Initiative (GCI) collaborated to deliver a free online course on Managing Children with Clubfoot.  The course was joint funded by ICRC and Physiopedia, the ACT Team and partners, including the University of Oxford, CURE International and Global Clubfoot Initiative have kindly provided content for the course, which is also being supplemented with additional material from global experts. Humanity & Inclusion donated the translation of a French version of the course.

Clubfoot is a complex, congenital deformity of the foot also known as ‘congenital talipes equinovarus’ (CTEV) caused by the abnormal development of a baby’s bones, ligaments and muscles whilst in the womb. Around the world, 150,000 – 200,000 babies with clubfoot are born each year, approximately 80% of these will be in low and middle income countries. Without treatment, the clubfoot deformity causes a lifetime of disability as the affected individual experiences pain and difficulty in walking. People with untreated clubfoot find it difficult to access education, employment and experience exclusion from society. However, most cases of clubfoot can be successfully treated by a multidisciplinary team of healthcare workers with methods that may include a combination of stretching, casting, and bracing.

The course provides a framework to develop theoretical principles for the management of children with clubfoot relevant in all contexts. It introduces the pathoanatomy, etiology and epidemiology underpinning idiopathic clubfoot, including: idiopathic in an infant, idiopathic clubfoot in the older child, relapse and atypical clubfoot.  The course explores assessment and the roles of the multidisciplinary team, as well as provide a theoretical understanding of management techniques and related clinical considerations. It will not teach practical skills or lead to any clinical qualification. The global network formed through this course allows for shared knowledge and experiences to support good health care and a better quality of life for children with clubfoot around the world.

Aim[edit | edit source]

This course aims to provide a basic theoretical understanding of clubfoot and to align global understanding of the theoretical principles underlying the management of children with clubfoot.

Intended Audience[edit | edit source]

This course is aimed at Physiotherapy and Physical Therapy professionals, clinicians, students and assistants; other interested health care professionals interested in this subject are more than welcome to participate. 

Learning Objectives[edit | edit source]

At the end of this course you will be able to:

  • Describe the role of three anatomical structures in the foot and ankle that play a role in Clubfoot
  • Identify the four major components characteristic of Clubfoot
  • Recognise the difference between Idiopathic, Positional and Secondary Clubfoot
  • Describe the incidence or prevalence of Clubfoot in your region
  • Summarise an example article of quality published evidence on the prevalence or incidence of Clubfoot
  • Identify the four key features of clubfoot using C-A-V-E
  • Interpret the Pirani Score to assess and monitor Clubfoot deformity
  • Explain the role of the multidisciplinary team in the management of Clubfoot
  • Examine the role of a Physiotherapist within the multidisciplinary team in the management of Clubfoot
  • Explain the role of parents/carers within the multidisciplinary team in the management of Clubfoot
  • Evaluate the use of the Ponseti Method in the management of Clubfoot
  • Identify when a Tenotomy is indicated
  • Explain the role of bracing in preventing recurrence of CAVE signs
  • Analyse the issue of adherence to the brace regime
  • Compare and contrast two types of different Foot Abduction Braces used in the management of Clubfoot
  • develop a treatment plan utilising evidence based therapeutic interventions based on an assessment of a child with Clubfoot
  • Recognise four common errors that may occur during Clubfoot Treatment
  • Identify two causes for Clubfoot Treatment not progressing
  • Describe three features of Atypical Clubfoot
  • Identify a sign of Recurrent Clubfoot Deformity evident during Gait
  • Discuss the difference in treatment required in Clubfoot in Older Children
  • Outline three key elements for a successful Clubfoot Programme.

Course Structure[edit | edit source]

This course is divided into 4 sections and it is suggested (but not required) that each section be completed over the duration of approximately a week. Please note that no deadlines are applied and this course can be started and completed according to your own schedule. We expect the required elements of each section/week to take around 4-6 hours depending on your schedule and learning style. Additionally there are many optional resources provided and if you choose to review these the course could take significantly longer to complete.

It’s not going to be easy, we’ll expect you to work hard for your completion certificate! You won’t be sitting back and watching webinars, we’ll expect you to undertake reading tasks, complete quizzes, perform literature searches and other learning activities. You’ll need to reflect on your own experiences and make written contributions to the discussion forum. This forum is where we can learn from each other’s experiences and knowledge from all around the world! At the end of the course, when you have completed all of the required elements, you will be able to download a certificate of completion.

Course Outline[edit | edit source]

  1. Section 1: Introduction to Clubfoot
  2. Section 2: Assessing Children with Clubfoot
  3. Section 3: Understanding the Management of Children with Clubfoot
  4. Section 4: Effective Management Considerations
  5. Section 5: Final Tasks and Optional Assignment

Types of learning activity involved[edit | edit source]

Reading Physiopedia pages, journal articles, book chapters. Watching videos and PowerPoint presentations. Attempting quizzes. Participating in an international discussion forum.

Cost[edit | edit source]

This course was offered for FREE in 2017. It is now only available to Full and Pro subscribers on Physioplus.

Where[edit | edit source]

This is a completely online course which will take place in Physiopedia's complimentary e-learning platform Physioplus -you can see the course details here. You will need need to set up a trial account to access the course which will become available on the site on 6 November 2017.

Time Commitment[edit | edit source]

Completing this course will involve approximately 16 hours of learning activities. These will be delivered in 4 sections that can be completed on a participant’s own schedule, however it is recommended that the course is completed over a 4 week period. There is an optional additional 2 hour activity for participants who wish to submit an assignment for a course distinction.

Language[edit | edit source]

There is an English and a French version of this course.

For the English course - although participants will only require basic English skills (reading skills are more important than conversational skills). Participants will be encouraged to be respectful and empathetic to those for whom English is not their first language (e.g. in the discussion forum).

Accreditation, Assessment and Certification[edit | edit source]

This course has been accredited by:

  1. Federation of State Boards of Physical Therapy (ProCert) (10 CCUs) - Alaska, Arizona, Arkansas, California, Colorado, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Wisconsin, Wyoming
  2. South African Society of Physiotherapy (16 CEUs Level 2)

In order to complete this course and receive a course completion certificate you will need to:

  1. Be part of the Physiopedia Plus Community Culture.
  2. Log as completed all the required learning activities (represented by the orange icons!).
  3. Actively and appropriately participate in the course discussions.
  4. Pass a final quiz with a score of 80% or more.
  5. Complete a course evaluation form.

Thanks![edit | edit source]

The Clubfoot MOOC was developed as a collaboration between Physiopedia, ICRC and GCI. Physiopedia and ICRC provided funding. The ACT Team and partners, including the University of Oxford, CURE International and Global Clubfoot Initiative kindly provided content for the course, which was supplemented with additional material from global experts. HI completed the French translation of the course.