{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:50:03Z","timestamp":1792799403631,"version":"4.5.0"},"reference-count":46,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MiracleFeet"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The Ponseti method of clubfoot treatment involves two phases: initial correction, usually including tenotomy; and bracing, to maintain correction and prevent relapse. Bracing should last up to four years, but in Uganda, approximately 21% of patients drop from clinical oversight within the first two years of using the brace. Our study compared 97 adherent and 66 non-adherent cases to assess the influential factors and effects on functional outcomes. We analyzed qualitative and quantitative data from clinical records, in-person caregiver interviews, and assessments of foot correction and functionality. Children who underwent tenotomy had 74% higher odds of adherence to bracing compared to those who did not undergo tenotomy. Conversely, children from rural households whose caregivers reported longer travel times to the clinic were more likely to be non-adherent to bracing (AOR 1.60 (95% CI: 1.11\u20132.30)) compared to those without these factors. Adhering to bracing for a minimum of two years was associated with improved outcomes, as non-adherent patients experienced 2.6 times the odds of deformity recurrence compared to adherent patients. Respondents reported transportation\/cost issues, family disruptions, and lack of understanding about the treatment method or importance of bracing. These findings highlight the need to address barriers to adherence, including reducing travel\/waiting time, providing ongoing education for caregivers on bracing protocol, and additional support targeting transportation barriers and household complexities.<\/jats:p>","DOI":"10.3390\/ijerph20146396","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T21:22:58Z","timestamp":1689801778000},"page":"6396","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Exploring Bracing Adherence in Ponseti Treatment of Clubfoot: A Comparative Study of Factors and Outcomes in Uganda"],"prefix":"10.3390","volume":"20","author":[{"given":"Marieke","family":"Dreise","sequence":"first","affiliation":[{"name":"MiracleFeet, Chapel Hill, NC 27514, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8368-7730","authenticated-orcid":false,"given":"Catherine","family":"Elkins","sequence":"additional","affiliation":[{"name":"MiracleFeet, Chapel Hill, NC 27514, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses Fisha","family":"Muhumuza","sequence":"additional","affiliation":[{"name":"CoRSU Hospital, Kisubi, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Musoke","sequence":"additional","affiliation":[{"name":"National Clubfoot Program Uganda, Kisubi, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3408-7362","authenticated-orcid":false,"given":"Tracey","family":"Smythe","sequence":"additional","affiliation":[{"name":"International Centre for Evidence in Disability, Department of Population Health, London School for Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town 7602, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1080\/09638280701240102","article-title":"Understanding the barriers to clubfoot treatment adherence in Uganda: A rapid ethnographic study","volume":"29","author":"McElroy","year":"2007","journal-title":"Disabil. 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