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The Dynamic Baropodometric Profile of Children with Idiopathic Toe-Walking

A Cross-Sectional Study

Patricia Martín-Casas Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Madrid, Spain.

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 PT, MSc, PhD
,
Alfonso Meneses-Monroy Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Madrid, Spain.

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 RN, MSc, PhD
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Juan Vicente Beneit-Montesinos Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Madrid, Spain.

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María de los Ángeles Atín-Arratibel Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Madrid, Spain.

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Gustavo Plaza-Manzano Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, Alcala University, Madrid, Spain.

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 PT, MSc, PhD
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Daniel Pecos-Martín Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, Alcala University, Madrid, Spain.

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 PT, MSc, PhD
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Tomás Gallego-Izquierdo Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, Alcala University, Madrid, Spain.

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 PT, MSc, PhD
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Cylie Williams Community Health, Peninsula Health, Frankston, Victoria, Australia.

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 BAppSc(Pod), PhD

Background:

Idiopathic toe-walking (ITW) gait may present in children older than 3 years and in the absence of a medical condition known to cause or be associated with toe-walking gait. It is unknown how this gait type changes pressure distribution in the growing foot. We sought to determine whether children with ITW gait exhibit different plantar pressures and temporal gait features than typically developing children.

Methods:

Children aged 3 to 6 years were recruited who had either a typical heel-toe gait pattern or a diagnosis of ITW. The ITW diagnosis was reported by the parent/caregiver and confirmed through history and physical examination. Temporal gait measures, peak pressures, and impulse percentages were measured. A minimum of ten unshod footprints were collected. Data were compared with unpaired t tests.

Results:

The study included 40 children with typical gait and 56 with ITW gait. The ITW group displayed lower peak pressures at the hallux, midfoot, and hindfoot (P < .05) and higher and lower pressure impulse percentages at the forefoot (P < .001) and hindfoot (P < .001), respectively. The ITW group spent a higher percentage of contact time at all areas of the forefoot and less at the midfoot and rearfoot (P < .05). There were no significant differences in total step duration and foot progression angle between groups (P > .05).

Conclusions:

There were differences in pressure distributions between groups. Understanding these differences may help us better understand the compensations or potential long-term impact that ITW gait may have on a young child's foot. Podiatric physicians may also consider the use of this equipment in the clinical setting to measure outcomes after treatment for ITW.

Corresponding author: Patricia Martín-Casas, PT, MSc, PhD, Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Plaza de Ramón y Cajal n° 3, Madrid, E-28040 Spain (E-mail: pmcasas@enf.ucm.es)