Assessing dynamic stability in children with idiopathic toe walking during overground walking

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-15 DOI:10.1016/j.clinbiomech.2025.106468

Michelle Gwerder , Michèle Widmer , Olivia Schären , Navrag B Singh , Morgan Sangeux , Elke Viehweger

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引用次数: 0

Abstract

Background

Children with idiopathic toe walking present with reduced ankle mobility, impaired balance, and difficulties in motor control. There is a need to diagnose idiopathic toe walking in a holistic manner and improve the monitoring of interventions. The aim is to assess dynamic stability with measures of margin of stability and whole-body angular momentum and evaluate their clinical relevance.

Methods

A retrospective cross-sectional study with 35 idiopathic toe walkers (23 male, mean age (SD) 10.0 (2.9) years) and 20 typically developing controls (10 male, 11.4 (2.8) years). All participants had a clinical gait analysis at the local hospital. Dynamic stability was assessed with margin of stability, whole-body angular momentum, GaitSD, and spatiotemporal gait parameters. Student t-tests with adjustments for multiple comparisons were performed.

Findings

Margin of stability in anterior direction was significantly shorter (ES = 1.29) and whole-body angular momentum in the coronal plane was significantly larger (ES = 0.90) in idiopathic toe walkers compared to typically developing children. No other results were below the set threshold for significance.

Interpretation

Children with idiopathic toe walking continue to use an immature, falling forward movement strategy to maintain forward momentum. It is probable that those children adopted toe walking behavior to support increased energy absorption during the initial fall. Furthermore, the addition of dynamic stability measures not only provides insight into their ability to balance, these measures also allow an understanding of the plausible strategies adopted during walking and could potentially improve diagnosis and quantification of therapeutic outcomes.

Abstract Image

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背景患有特发性足趾行走症的儿童表现为踝关节活动度降低、平衡能力受损以及运动控制困难。有必要对特发性足趾行走进行全面诊断，并改进对干预措施的监测。方法对 35 名特发性足趾行走患者（23 名男性，平均年龄（SD）10.0（2.9）岁）和 20 名发育正常的对照组患者（10 名男性，11.4（2.8）岁）进行回顾性横断面研究。所有参与者均在当地医院进行了临床步态分析。动态稳定性是通过稳定幅度、全身角动量、GaitSD 和时空步态参数来评估的。研究结果与发育正常的儿童相比，特发性足趾畸形儿童在前方方向的稳定幅度明显较短（ES = 1.29），在冠状面上的全身角动量明显较大（ES = 0.90）。其他结果均未低于设定的显著性阈值。这些儿童采用脚趾行走的行为很可能是为了支持在最初跌倒时增加能量吸收。此外，增加动态稳定性测量不仅可以了解他们的平衡能力，还可以了解他们在行走过程中采取的合理策略，并有可能改善诊断和量化治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.