Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet
Background: Equinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore, we conducted this review to estimate the prevalence of equinus foot in CP. Methods: Eight databases were searched. Our primary outcome was t...
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| Published in | Journal of clinical medicine Vol. 10; no. 18; p. 4128 |
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| Main Authors | , , , , , |
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| Language | English |
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| Abstract | Background: Equinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore, we conducted this review to estimate the prevalence of equinus foot in CP. Methods: Eight databases were searched. Our primary outcome was the prevalence of equinus foot in CP patients. Subgroup analysis was conducted based on study design, the laterality of CP, and whether equinus foot was defined or not. Results: The prevalence of equinus foot in CP was 93% (95% CI: 71–99). The prevalence was 99% (95% CI: 55–100), 96% (95% CI: 57–100), and 65% (95% CI: 37–86) in unilateral, both, and bilateral CP, respectively. Based on study design, equinus foot prevalence was 92% (95% CI: 34–100) in case series and 62% (95% CI: 47–74) in cohort studies. Four studies reported definition criteria for equinus foot, with a pooled prevalence rate of equinus foot of 99% (95% CI: 36–100) compared to a rate of 89% (95% CI: 59–98) among studies that lacked a definition criterion. Conclusions: This is the first meta-analysis to address the prevalence of equinus foot in CP patients. Although its prevalence is very high, our findings should be interpreted with caution due to the presence of multiple limitations, such as the lack of standardized definition criteria for equinus foot, the inappropriate study design, the wide confidence interval of equinus foot rate, and the small number of studies investigating it as a primary outcome. |
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| AbstractList | BACKGROUNDEquinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore, we conducted this review to estimate the prevalence of equinus foot in CP. METHODSEight databases were searched. Our primary outcome was the prevalence of equinus foot in CP patients. Subgroup analysis was conducted based on study design, the laterality of CP, and whether equinus foot was defined or not. RESULTSThe prevalence of equinus foot in CP was 93% (95% CI: 71-99). The prevalence was 99% (95% CI: 55-100), 96% (95% CI: 57-100), and 65% (95% CI: 37-86) in unilateral, both, and bilateral CP, respectively. Based on study design, equinus foot prevalence was 92% (95% CI: 34-100) in case series and 62% (95% CI: 47-74) in cohort studies. Four studies reported definition criteria for equinus foot, with a pooled prevalence rate of equinus foot of 99% (95% CI: 36-100) compared to a rate of 89% (95% CI: 59-98) among studies that lacked a definition criterion. CONCLUSIONSThis is the first meta-analysis to address the prevalence of equinus foot in CP patients. Although its prevalence is very high, our findings should be interpreted with caution due to the presence of multiple limitations, such as the lack of standardized definition criteria for equinus foot, the inappropriate study design, the wide confidence interval of equinus foot rate, and the small number of studies investigating it as a primary outcome. Background: Equinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore, we conducted this review to estimate the prevalence of equinus foot in CP. Methods: Eight databases were searched. Our primary outcome was the prevalence of equinus foot in CP patients. Subgroup analysis was conducted based on study design, the laterality of CP, and whether equinus foot was defined or not. Results: The prevalence of equinus foot in CP was 93% (95% CI: 71–99). The prevalence was 99% (95% CI: 55–100), 96% (95% CI: 57–100), and 65% (95% CI: 37–86) in unilateral, both, and bilateral CP, respectively. Based on study design, equinus foot prevalence was 92% (95% CI: 34–100) in case series and 62% (95% CI: 47–74) in cohort studies. Four studies reported definition criteria for equinus foot, with a pooled prevalence rate of equinus foot of 99% (95% CI: 36–100) compared to a rate of 89% (95% CI: 59–98) among studies that lacked a definition criterion. Conclusions: This is the first meta-analysis to address the prevalence of equinus foot in CP patients. Although its prevalence is very high, our findings should be interpreted with caution due to the presence of multiple limitations, such as the lack of standardized definition criteria for equinus foot, the inappropriate study design, the wide confidence interval of equinus foot rate, and the small number of studies investigating it as a primary outcome. |
| Author | Horsch, Axel Seide, Svenja Zeaiter, Nancy Ghandour, Maher Klotz, Matthias C M Platzer, Hadrian |
| AuthorAffiliation | 3 Institute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, Germany; seide@imbi.uni-heidelberg.de 1 Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69118 Heidelberg, Germany; hadrian.platzer@med.uni-heidelberg.de (H.P.); dr.ghandour@hotmail.com (M.G.) 2 Marienkrankenhaus Soest, Orthopedics and Trauma Surgery, 59494 Soest, Germany; mcmklotz@gmx.net 4 Department of Plastic Surgery, Al Zahraa Hospital University Medical Center, Beirut 1003, Lebanon; zeaiternancy@gmail.com |
| AuthorAffiliation_xml | – name: 2 Marienkrankenhaus Soest, Orthopedics and Trauma Surgery, 59494 Soest, Germany; mcmklotz@gmx.net – name: 1 Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69118 Heidelberg, Germany; hadrian.platzer@med.uni-heidelberg.de (H.P.); dr.ghandour@hotmail.com (M.G.) – name: 3 Institute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, Germany; seide@imbi.uni-heidelberg.de – name: 4 Department of Plastic Surgery, Al Zahraa Hospital University Medical Center, Beirut 1003, Lebanon; zeaiternancy@gmail.com |
| Author_xml | – sequence: 1 givenname: Axel surname: Horsch fullname: Horsch, Axel – sequence: 2 givenname: Matthias C. M. surname: Klotz fullname: Klotz, Matthias C. M. – sequence: 3 givenname: Hadrian orcidid: 0000-0001-9805-3810 surname: Platzer fullname: Platzer, Hadrian – sequence: 4 givenname: Svenja surname: Seide fullname: Seide, Svenja – sequence: 5 givenname: Nancy surname: Zeaiter fullname: Zeaiter, Nancy – sequence: 6 givenname: Maher surname: Ghandour fullname: Ghandour, Maher |
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| Snippet | Background: Equinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore,... BACKGROUNDEquinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore,... |
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| SubjectTerms | Ankle Cerebral palsy Clinical medicine Gait Meta-analysis Review Systematic review |
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| Title | Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet |
| URI | https://www.proquest.com/docview/2576416648 https://search.proquest.com/docview/2577454322 https://pubmed.ncbi.nlm.nih.gov/PMC8465417 |
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