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Table 3 The Clubfoot Assessment Protocol (version 1.0)

From: The clubfoot assessment protocol (CAP); description and reliability of a structured multi-level instrument for follow-up

Name:    Date of birth:   
Date of assessment:    Assessment number:   
Side: O Left O Right    
Rating 0 1 2 3 4
Passive mobility
1. Dorsiflexion < -10° -10°-< 0° 0°- < +10° +10°- +20° >+20°
2. Plantar flexion 0°- < 10° 10°- < 20° 20°-< 30° 30°- 40° >40°
3. Varus/valgus >20°var 20°-< 10°var 10° -< 0°var 0°- neutral >0°vlg
4. Derotation >20°inv 20°-< 10°inv 10°- < 0°inv 0°- 10°evr >10°evr
5. Add/abd >20°add 20°-< 10°add 10°- < 0°add 0°- neutral >0°abd
6. Tightness + tight tight   soft-tight soft
7. Flx.dig.long. + reduced   reduced   normal
8. Flx.dig.hall. + reduced   reduced   normal
Muscle function (strength)
9. M. peroneus absent/poor   reduced   normal
10. M. ext.dig.long absent/poor   reduced   normal
11. M. sol./gastr. absent/poor   reduced   normal
Morphology
12. Tibial rotation + inw.   inw.   normal
13. Calcaneus position >10 varus   >0 varus <10   neutral/vlg
14. Forefoot position >20° add.   >10 add. <20°   add<10°
15. Foot arch + cavus   cavus   normal
Motion quality
I
16. Walking + deviant deviant   slightly deviant normal
17. Toe walking cannot deviant   slightly deviant normal
18. Heel walking cannot deviant   slightly deviant normal
19. Squatting cannot deviant   slightly deviant normal
20. Running + deviant deviant   slightly deviant normal
II
21. One legstand cannot deviant   slightly deviant normal
22. Hop1leg cannot deviant   slightly deviant normal
  1. Extra notes: Structured questions about pain, stiffness, shoe problems, physical condition, activity level, sports and social participation and patient/parent satisfaction.
  2. + = pronounced / very, var= varus, vlg= valgus, inv = inversion, evr = eversion, add = adduction, abd = abduction. inw = inward rotation, flx.dig.long. = length of M. flexor digiti longus, flx.dig.hall. = length of M. flexor digiti hallucis
  3. ©The CAP is copyright to Hanneke Andriesse, 2003.