The current treatment of club foot in the UK is very well managed and there are high success rates achieved by experienced clinical teams. However, parents still find the Boots and Bar treatment phase challenging and improving this phase of the treatment is the goal of the Cunningham Brace.
LOC believes that the introduction of the Cunningham Brace to the UK needs to be managed carefully. Therefore we will only see patients who have been referred to us or who have been seen by Club foot and Ponsetti experts.
Only if they determine that the club foot condition has been fully corrected following the Ponseti treatment will LOC offer a Cunningham Brace, in preference to the traditional boots and bar bracing, to complete the treatment.
Following the decision to proceed with the Cunningham Brace, measurements will be taken at our Kingston clinic. The fitting of the brace will take place about a week later. To ensure the brace is fitting correctly we would want to see the baby on consecutive days.
LOC will then manage the treatment with appointments in our clinic and by Skype.
The Cunningham brace is brainchild of Jerald Cunningham, a certified American prosthetist and orthotist.
It is a flexible brace that is only fitted to the affected leg and allows movement for all of the normal activities.
Developed from observing the distress to both child and parent with the Boots and Bar approach.
Jerald Cunningham is a board-certified prosthetist and orthotist (ABC) with 20 years of experience in the field.
He has also been a guest lecturer for the University of New England's PhD Physical Therapy program.
Jerald is constantly working to bring new, patient-inspired solutions to reality in the form of the Cunningham brace.
Adult patients of club foot can have trouble walking with curled toes, fused ankles, callouses and pain.
At LOC, we offer bespoke orthotic treatments such as insoles, custom-made footwear and AFOs.
Upon consultation at LOC, we can discuss your goals and what you want to achieve via treatment.
The affected foot will look like it’s rotating internally at the ankle, with the foot pointing down and inwards. The soles of the feet face backwards. If left untreated, people with club feet often appear to be walking on their ankles or the sides of their feet.
The big difference is that the Cunningham Brace is flexible and only fitted to the affected leg. This allows for the sort of dynamic movement you’d expect in babies, such as crawling, rolling and standing. Greater activity helps build a more developed muscular system – particularly calf muscles. Anecdotally we’ve seen a lot more symmetry in calf muscles using the Cunningham Brace than boots and bar. And because it’s a different kind of mechanism we don’t have to strap the feet up so tightly, which reduces issues such as blistering on the legs.
At your first appointment we will take measurements and fit your child with their first Cunningham Brace. We’ll show you how to put the brace on and take it off and book you in for a review a week later. We then schedule a series of reviews as your child grows to check progress and ensure that your child is maintaining the correction. This can be done in the clinic or virtually via a system like Skype. There are lots of simple things we can adjust to encourage correct development.
The Cunningham Brace is made from a series of measurements that we can either take in the clinic or help you to take during a virtual appointment. We hold a range of Cunningham braces in stock that we can adapt to the correct size and foot type of your baby. This process normally takes a few hours unless your child has a size that is out of the normal range or we do not have it in stock.
It depends on your child and the complexity of their case. On average, though, we’ll be looking to review your baby’s progress once a month over the course of treatment.
Treatment lasts about two years – this is around one-third of the time other methods require. In the first year, your baby will wear the brace for 23 hours a day – compared with boots and bar which can only be done for three months. This means we can help correct your baby’s foot while their tissue and bones are at their softest and most compliant. Once your baby is standing, they will only wear the brace during nighttime and naps.
Very often parents contact us before their baby is even born, having discovered the club foot on a scan. However, they first need to go through the Ponseti method with their consultant and then be triaged by a specialist physiotherapist before we can start treatment.
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