Dataset Information

Do external stimuli impact the gait of children with idiopathic toe walking? A study protocol for a within-subject randomised control trial.

ABSTRACT:

Introduction

Frequently, toe walking gait is the result of disease processes, trauma or neurogenic influences. Idiopathic toe walking (ITW) is, by definition, the diagnosis of a toe walking gait adopted in the absence of one of these medical conditions. Long-term ITW has been associated with reduced ankle range of motion. Reported treatments have included serial casting, Botulinum toxin type A or surgery to improve the ankle range of motion. Investigating the impact of simple and non-invasive treatment options for ITW is important for future research and clinical outcomes. This study investigates the immediate impact of footwear, footwear with orthotics and whole body vibration on ITW to determine if any one intervention improves heel contact and spatial-temporal gait measures. This determination is important for future clinical trials into treatment effectiveness.

Methods and analysis

Design

this protocol describes a within-subject randomised controlled trial that measures changes in gait following changes in external stimuli.

Participants

15 children diagnosed with an ITW gait will be recruited from the Victorian Paediatric Rehabilitation Service at Monash Children's Hospital Toe Walking Clinic provided they have ITW and meet the inclusion criteria.

Procedure

participants will have their gait recorded walking barefoot, in usual footwear, a custom-made, full-length carbon fibre orthotic in usual footwear and following whole body vibration. Outcome measures will include the presence of bilateral heel contact preintervention and postintervention, stride length (cm), stride width (cm), left and right stride time (s), left and right stance and swing percentage of the gait cycle, gait velocity (m/s), left and right foot toe in/toe out angle (°) and weight-bearing lunge pre and post each condition.

Ethics and dissemination

The results of this study will be published at the conclusion and have been approved by Southern Health HREC:12102B.

Clinical trial registry number

ACTRN12612000975897.

SUBMITTER: Williams CM

PROVIDER: S-EPMC3612749 | biostudies-literature | 2013 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Do external stimuli impact the gait of children with idiopathic toe walking? A study protocol for a within-subject randomised control trial.

Williams Cylie M CM Michalitsis Joanne J Murphy Anna A Rawicki Barry B Haines Terry P TP

BMJ open 20130301 3

<h4>Introduction</h4>Frequently, toe walking gait is the result of disease processes, trauma or neurogenic influences. Idiopathic toe walking (ITW) is, by definition, the diagnosis of a toe walking gait adopted in the absence of one of these medical conditions. Long-term ITW has been associated with reduced ankle range of motion. Reported treatments have included serial casting, Botulinum toxin type A or surgery to improve the ankle range of motion. Investigating the impact of simple and non-inv ...[more]

PMID: 23454667

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Project description:ObjectivesTo determine if children with idiopathic toe walking (ITW) reach Australian 24-hour movement guidelines. Additional objectives were to identify any factors associated with moderate to vigorous physical activity time of children with ITW.DesignCross sectional.SettingPrivate practice, public health outpatient, community clinics.ParticipantsChildren between 4 and 14 years, who toe walked and had no medical conditions known to cause ITW.Outcome measuresPhysical activity intensity, sedentary behaviour and sleep data were collected via an ActiGraph. Physical activity level intensity data were triangulated with the Child Leisure Activities Study Survey (CLASS) to highlight the subjective nature of parent-reported measures. Health related quality of life information was collected using the Parent-Proxy and Child-Self Report Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scale. Regression analyses were used to explore individual factors associated with moderate to vigorous physical activity.ResultsTwenty-seven participants, 17(63%) male, age mean = 6.62 (SD = 2.29) years, provided information on physical activity (CLASS n = 18, ActiGraph n = 22), physical functioning and psychosocial functioning domains on the PedsQL (Parent-Proxy n = 25, Child n = 22). All participants exceeded Australian recommendations for physical activity, 44% (8/18) met recommended screen time amounts, and two (9%) met recommended sleep times. The Child-Self Report PedsQL scale score of social functioning was the only factor associated with an increase in physical activity (Coef = 0.48, 95%CI = 0.09 to 0.87, p = 0.019).ConclusionParticipants achieved high levels of daily moderate to vigorous physical activity, and this was associated with social functioning. Given current uncertainty regarding benefits and effectiveness of treatment choices for children who have ITW, these findings should encourage clinicians to consider how their treatment recommendations interact with the PA level and sleep of children with ITW. Any treatment choice should also be implemented with consideration of how it may impact social functioning. This study had a small sample size therefore results should be cautiously interpreted and not generalised to all children with ITW.

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Dataset Information

Do external stimuli impact the gait of children with idiopathic toe walking? A study protocol for a within-subject randomised control trial.

Introduction

Methods and analysis

Design

Participants

Procedure

Ethics and dissemination

Clinical trial registry number

Publications

Do external stimuli impact the gait of children with idiopathic toe walking? A study protocol for a within-subject randomised control trial.

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