Armand S, Watelain E, Mercier M et al.: Identification and classification of toe-walkers based on ankle kinematics, using a data-mining method. Gait Posture 23: 240, 2006.
Alvarez C, De Vera M, Beauchamp R et al.: Classification of idiopathic toe walking based on gait analysis: development and application of the ITW severity classification. Gait Posture 26: 428, 2007.
Lorentzen J, Willerslev-Olsen M, Hüche-Larsen H et al.: Maturation of feedforward toe walking motor program is impaired in children with cerebral palsy. Brain 142: 526, 2019.
Mary P, Servais L, Vialle R: Neuromuscular diseases: diagnosis and management. Orthop Traumatol Surg Res 104: S89, 2018.
Soto-Insuga V, Moreno-Vinués B, Losada-Del-Pozo R et al.: Do children with attention deficit and hyperactivity disorder (ADHD) have a different gait pattern? Relationship between idiopathic toe-walking and ADHD [in Spanish]. An Pediatr (Barc) 88: 191, 2018.
Arik A, Aksoy C, Aysev A et al.: Lower-extremity rotational profile and toe-walking in preschool children with autism spectrum disorder. J Pediatr Orthop B 27: 530, 2018.
Baber S, Michalitsis J, Fahey M et al.: Comparison of the birth characteristics of idiopathic toe walking and toe walking gait due to medical reasons. J Pediatr 171: 290, 2016.
Caserta A, Morgan P, Williams C: Identifying methods for quantifying lower limb changes in children with idiopathic toe walking: a systematic review. Gait Posture 67: 181, 2019.
Ruzbarsky JJ, Scher D, Dodwell E: Toe walking: causes, epidemiology, assessment, and treatment. Curr Opin Pediatr 28: 40, 2016.
Wong C, Speedtberg M, Bencke J et al.: Idiopathic toe walking: to treat or not to treat? that is the question. MOJ Orthop Rheumatol 10: 94, 2018.
Williams CM, Tinley P, Curtin M: Idiopathic toe walking and sensory processing dysfunction. J Foot Ankle Res 3: 16, 2010.
Michalitsis J, Murphy AT, Rawicki B et al.: Full length foot orthoses have an immediate treatment effect and modify gait of children with idiopathic toe walking. Gait Posture 68: 227, 2019.
Pomarino D, Ramírez-Llamas J, Pomarino A: Idiopathic toe walking: tests and family predisposition. Foot Ankle Spec 9: 301, 2016.
Engström P, Tedroff K: The prevalence and course of idiopathic toe-walking in 5-year-old children. Pediatrics 130: 279, 2012.
Engström P, Van’t Hooft I, Tedroff K: Neuropsychiatric symptoms and problems among children with idiopathic toe-walking. J Pediatr Orthop 32: 848, 2012.
Morozova OM, Chang TF, Brown ME: Toe walking: when do we need to worry? Curr Probl Pediatr Adolesc Health Care 47: 156, 2017.
Martín-Casas P, Meneses-Monroy A, Ballestero-Pérez R et al.: Dynamic pedobarographic classification of idiopathic toe-walkers for therapeutical indication. Clin Salud 28: 17, 2017.
Burke JF, Skolarus LE, Callaghan BC et al.: Choosing wisely: highest-cost tests in outpatient neurology. Ann Neurol 73: 679, 2013.
Williams CM, Tinley P, Curtin M: The Toe Walking Tool: a novel method for assessing idiopathic toe walking children. Gait Posture 32: 508, 2010.
López-Bustos-de-las Heras R, Cano-de-la-Cuerda R, De-la-Llave-Rincón AI et al.: Translation and transcultural adaptation of the Toe Walking Tool: screening tool of toe walking patients. Rev Neurol 69: 99, 2019.
World Medical Association: World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310: 2191, 2013.
Yaliman A, Kesiktas N, Ozkaya M et al.: Evaluation of intrarater and interrater reliability of the Wisconsin Gait Scale with using the video taped stroke patients in a Turkish sample. NeuroRehabilitation 34: 253, 2014.
Mokkink LB, Terwee CB, Patrick DL et al.: The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 19: 539, 2010.
Portney LG, Watkins MP: “Concepts of Measurement,” in Foundations of Clinical Research: Applications to Practice, 3rd Ed, edited by LG Portney, p 180, Pearson/Prentice Hall, Hoboken, NJ, 2009.
Tavakol M, Dennick R: Making sense of Cronbach’s alpha. Int J Med Educ 2: 53, 2011.
Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 33: 159, 1977.
Terwee CB, Bot SD, de Boer MR et al.: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60: 34, 2007.
Polit DF, Beck CT, Owen SV: Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health 30: 459, 2007.
Yoon DY, Scott K, Hill MN et al.: Review of three tests of motor proficiency in children. Percept Mot Skills 102: 543, 2006.
De-Andrés-Beltrán B, Rodríguez-Fernández ÁL, Güeita-Rodríguez J et al.: Evaluation of the psychometric properties of the Spanish version of the Denver Developmental Screening Test II. Eur J Pediatr 174: 325, 2015.
Hadders-Algra M, Tacke U, Pietz J et al.: Reliability and predictive validity of the Standardized Infant NeuroDevelopmental Assessment neurological scale. Dev Med Child Neurol 61: 654, 2019.
Background: The Toe Walking Tool (TWT) was developed in Australia as a valid and reliable screening tool for children who toe-walk. However, psychometric properties of the Spanish version of the TWT have not been studied. The aim of this study was to assess psychometric properties and clinical usefulness of the Spanish version of the TWT.
Methods: A cross-sectional study was conducted. Twelve children were assessed with the TWT. Intrarater and interrater reliability and agreement were calculated using the intraclass correlation coefficient (ICC) and the Fleiss kappa method for multiple raters. Internal consistency and construct validity were assessed with the Kuder-Richardson formula 20 coefficient and known-group methods, respectively. Sensitivity and specificity were analyzed using the receiver operating characteristic curve. The Content Validity Index was calculated to determine clinical usefulness.
Results: An excellent intrarater (ICC = 1) and interrater reliability (ICC = 0.8), moderate interrater agreement (Fleiss kappa, 0.6), strong internal consistency (Kuder-Richardson formula 20 coefficient, 0.86), and very good construct validity were found. Sensitivity and specificity results were appropriate (area under the curve, 0.845). The Content Validity Index was 0.906, suggesting high usefulness.
Conclusions: The Spanish version of the TWT was found to be a valid, reliable and useful screening tool for children who toe-walk, providing evidence for its recommendation.