Dynamic pedobarographic classification of idiopathic toe-walkers for therapeutical indication

Abstract

Idiopathic toe-walkers (ITWs) pedobarographic analysis has not been described yet nor its possible relationship with orthopedical and developmental characteristics. The objective of this research is to develop a dynamic pedobarographic classification of ITWs to propose a specific therapeutical approach. Through an observational study, 56 ITWs aged 3-6 years were classified by their initial foot contact; differences between idiopatic toe-walking (ITW) types and with respect to 40 control children were calculated by means of ANOVA and Student t-tests. The results show that the three ITW types displayed different step models for pressure and impulse distribution and also for temporal development (p < .05). They also showed different orthopedic and developmental characteristics (p < .05). As a whole, they demonstrated different severity levels, which suggest different therapeutical indications. This study confirms the convenience of a specific orthopedic, developmental, and gait assessment in ITW to clarify therapeutical indication.

Some children with idiopathic toe walking display sensory processing difficulties but not all: A systematic review

“…The search yielded 192 articles, with 178 excluded through title and abstract screening (Figure 1). Two additional articles were included through forward, and backward screening of included article citations 28,29 with 12 full‐text articles included (Figure 1). Two studies that appeared to meet the inclusion criteria were excluded as they were intervention studies 11,21 .…”

“…34 No significant differences were reported using the CUMAIN (n = 96) to describe the visual perception between groups (ITW mean = 54.91, SD = 26.10 vs. TD mean = 70.75, SD = 16.19). 29 Table 2 outlines the results of the critical appraisal tool (CASP).…”

“…Three articles used the Sensory Profile, 9,33,35 four used the Sensory Processing Measure (SPM) 12,30,32,34 and one (n = 96) used the Cuestionario de Madurez Neuropsicológica Infantil (CUMAIN). 29 No data were suitable for meta-analysis due to missing and differing data formats.…”

Early identification of toe walking gait in preschool children - Development and application of a quasi-automated video screening procedure

“…The clinical confirmation took 7 hours and therefore, the testing is the most time-consuming part of the process, but if included as part of a larger test-package in a cohort, the time consumption seems acceptable. Comparing to the golden standard methods of 3-D gait analysis or pedography 17,19 that can take up to 90 minutes without data processing and can be challenging to perform on young children, the QAS is less time consuming per child, and can be performed in a setting that is more familiar to the child. Also, considering the known variability of especially idiopathic toe walking 13 , false negatives could also be an issue with 3-D gait analysis or pedography applied in a large cohort.…”

“…In children with ITW gait observations are often variable 13 making detection difficult. Some methods utilizing inertial sensors 14,15 or pressure-sensitive insoles 16 have been developed for toe walking detection, and 3-D gait analysis 17,18 plus pedographic measurements 19 are considered the gold standards for classification of toe walking. These methods can, however, be difficult to apply as a screening procedure of larger groups of children, due to feasibility issues and extensive equipment requirements.…”