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Postural Control and Muscle Endurance in Children With Idiopathic Toe-Walking

Deniz Tuncer Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey.

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H. Nilgun Gurses Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey.

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Hakan Senaran Department of Orthopedics and Traumatology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

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Gokcer Uzer Department of Orthopedics and Traumatology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

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Ibrahim Tuncay Department of Orthopedics and Traumatology, Acibadem Maslak Hospital, Istanbul, Turkey.

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Background: Children with idiopathic toe-walking (ITW) may experience difficulty during postural tasks and are more likely to perceive physical activity as difficult and challenging. This study aimed to compare postural control and muscle endurance in children with ITW and healthy controls.

Methods: This cross-sectional study was conducted with 16 children with ITW (age, 10.88 ± 2.06) and 16 age-matched controls (age, 11.69 ± 1.99). Postural control was evaluated with the tests of the Biodex Balance System (postural stability, limits of stability, and modified clinical test of sensory interaction in balance) and the Balance Error Scoring System, which assesses static balance in six different conditions. Muscle endurance tests were the 1-min sit-to-stand test, the 30-sec sit-up test, and the Biering-Sorenson test.

Results: There was a significant difference between the two groups in the postural stability (P < .05), limits of stability (P < .01), and modified clinical test of sensory interaction in balance (P < .01) tests of the Biodex Balance System as well as the firm surface (P = .032), foam surface (P < .001), and total surface (P < .001) scores of the Balance Error Scoring System. Although there was a significant difference between the two groups in the 1-min sit-to-stand test (P = .016), no differences were found in the 30-sec sit-up test (P = .896) or the Biering-Sorenson test (P = .506).

Conclusions: This comparative study showed that children with ITW had decreased postural control compared with their healthy peers. Although the lower-extremity muscle endurance of children with ITW was weaker than that of their peers, no difference was observed in terms of trunk muscle endurance.

Corresponding author: Deniz Tuncer, PhD, Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Merkez Mahallesi, Silahtarağa Caddesi, #189, Eyupsultan, Istanbul 34050, Turkey. (E-mail: dtuncer@bezmialem.edu.tr)
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