The role of the Pirani scoring system in the management of club foot by the
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Ponseti method
Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 8, 1082-1084.
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Early results of a physiotherapist-delivered Ponseti service for the management of idiopathic congenital talipes equinovarus foot deformity
Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 8, 1085-1089.
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Does the Pirani score predict relapse in clubfoot?
Goriainov V, Judd J, Uglow M.
J Child Orthop. 2010 Oct;4(5):439-44.
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The clubfoot assessment protocol (CAP); description and reliability
of a structured multi-level instrument for follow-up
Hanneke Andriesse*1, Gunnar Hägglund1 and Gun-Britt Jarnlo2
This tool can be easily used within the clinical setting, used for monitoring developtment of a post treatment TEV. On assessment deteriation can be measured and referral made upon results.
Taken from Article
Abstract
Abstract
Background: In most clubfoot studies, the outcome instruments used are designed to evaluate classification or long-term
cross-sectional results. Variables deal mainly with factors on body function/structure level. Wide scorings intervals and total sum
scores increase the risk that important changes and information are not detected. Studies of the reliability, validity and
responsiveness of these instruments are sparse. The lack of an instrument for longitudinal follow-up led the investigators to
develop the Clubfoot Assessment Protocol (CAP).
The aim of this article is to introduce and describe the CAP and evaluate the items inter- and intra reliability in relation to patient
age.
Methods: The CAP was created from 22 items divided between body function/structure (three subgroups) and activity (one
subgroup) levels according to the International Classification of Function, Disability and Health (ICF). The focus is on item and
subgroup development.
Two experienced examiners assessed 69 clubfeet in 48 children who had a median age of 2.1 years (range, 0 to 6.7 years). Both
treated and untreated feet with different grades of severity were included. Three age groups were constructed for studying the
influence of age on reliability. The intra- rater study included 32 feet in 20 children who had a median age of 2.5 years (range, 4
months to 6.8 years).
The Unweighted Kappa statistics, percentage observer agreement, and amount of categories defined how reliability was to be
interpreted.
Results: The inter-rater reliability was assessed as moderate to good for all but one item. Eighteen items had kappa values >
0.40. Three items varied from 0.35 to 0.38. The mean percentage observed agreement was 82% (range, 62 to 95%). Different
age groups showed sufficient agreement. Intra- rater; all items had kappa values > 0.40 [range, 0.54 to 1.00] and a mean
percentage agreement of 89.5%. Categories varied from 3 to 5.
Conclusion: The CAP contains more detailed information than previous protocols. It is a multi-dimensional observer
administered standardized measurement instrument with the focus on item and subgroup level. It can be used with sufficient
reliability, independent of age, during the first seven years of childhood by examiners with good clinical experience.
A few items showed low reliability, partly dependent on the child's age and /or varying professional backgrounds between the
examiners. These -
Interobserver reliability in Pirani clubfoot severity scoring between a paediatric orthopaedic surgeon and a physiotherapy assistant.
Shaheen S, Jaiballa H, Pirani S.
J Pediatr Orthop B. 2012 Feb 14.
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Photographic recording of the features of the Pirani classification for club feet - A Case Study.
Huntley JS.
J Vis Commun Med. 2013 Dec;36(3-4):117-120.
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Inter-rater reliability of physiotherapists using the Pirani scoring system for clubfoot: comparison with a modified five-point scale.
Harvey, Nicole J.; Mudge, Anita J.; Daley, Deborah T.; Sims, Susan K.; Adams, Roger D.
Journal of Pediatric Orthopaedics B: August 20, 2014
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THE INTER-OBSERVER RELIABILITY OF THE PIRANI SCORE OF CLUBFOOT
H Steck and A Robertson
Bone Joint J 2014 vol. 96-B no. SUPP 13 21
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Correlation of Pirani and Dimeglio scores with number of Ponseti casts required for clubfoot correction.
Gao R, Tomlinson M, Walker C.
J Pediatr Orthop. 2014 Sep;34(6):639-42
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A Clinical Evaluation of the Pirani and Dimeglio Idiopathic Clubfoot Classifications
Dan Cosma, MD, PhD, Dana Elena Vasilescu, MD, PhD
The Journal of Foot and Ankle Surgery; Articles in Press
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A comparison between orthopedic surgeon and allied health worker in pirani score.
Jillani SA, Aslam MZ, Chinoy MA, Khan MA, Saleem A, Ahmed SK
J Pak Med Assoc. 2014 Dec;64(12 Suppl 2):S127-30.
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The Heel Pad in Congenital Idiopathic Clubfoot: Implications of Empty Heel for Clinical Severity Assessment.
Adegbehingbe OO, Asuquo JE, Joseph MO, Alzahrani M, Morcuende JA
Iowa Orthop J. 2015;35:169-174.
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Interobserver variability in Pirani clubfoot severity scoring system between the orthopedic surgeons.
Jain S, Ajmera A, Solanki M, Verma A.
Indian J Orthop 2017;51:81-5
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Interobserver variability in Pirani clubfoot severity scoring system between the orthopedic surgeons.
Jain S et al
Indian J Orthop. 2017 Jan-Feb;51(1):81-85. doi: 10.4103/0019-5413.197551.
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Predictive value of Pirani scoring system for tenotomy in the management of idiopathic clubfoot
Badmus Hakeem David, Adegbehingbe Olayinka O, Esan Oluwadare, ...
Journal of Orthopaedic Surgery June 15, 2017
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Significance Of Pirani Score at Bracing-Implications for Recognizing A Corrected Clubfoot
Mansoor Ali Khan et al
Iowa Orthop J. 2017; 37: 151–156.
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Assessment of impact of patient’s age at presentation and Pirani score on
treatment duration in clubfoot
Singh V B, Chaurasia A K, Lakhtakia P K
Mustansiriya Medical Journal Volume 16 Issue 3 December 20
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Comparison of Dimeglio and Pirani score in predicting number of casts and need for tenotomy in clubfoot correction using the Ponseti method
Manuele LampasiCaterina Novella AbatiCamilla BettuzziStefano StilliGiovanni Trisolino
International Orthopaedics: 29 March 2018
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Significance Of Pirani Score at Bracing-Implications for Recognizing A Corrected Clubfoot.
Khan MA et al
Iowa Orthop J. 2017;37:151-156.
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Interobserver reliability of pirani clubfoot severity scoring between an orthopedic surgeon, a resident doctor, and a nonmedical counsellor at a clubfoot clinic
Pulak Sharma et al
Year : 2018 | Volume : 52 | Issue : 6 | Page : 645-650
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Prediction of Number of Casts and Need of Tenotomy Using Pirani Score in the Management of Clubfoot.
Ayehualem S et al
The Journal of Craniofacial Surgery [07 Jun 2019]
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Prediction of Number of Casts and Need of Tenotomy Using Pirani Score in the Management of Clubfoot.
Ayehualem S et al
J Craniofac Surg. 2019 Jul;30(5):e477-e481
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Radiological study of anatomical bony arrangement of the clubfoot deformity and its correlation with the Pirani clinical scoring system: A multicenter study
Mustafa Hayder El Hadi, Mohamed Abdelsalam Nurein, Mustafa Abbas El Sheikh Bader, Mohamed Mahdy Ali Salih, Haydar Elhadi Babikir.
Sudan J Paed. 2019; 19(2): 101-109doi: 10.24911/SJP.106-1573461977
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Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?
Mohammad Ali Tahririan, Mohammadreza Piri Ardakani & Sara Kheiri
Journal of Orthopaedic Surgery and Research volume 16, Article number: 238 (2021)
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