Toe Walking Tool.

Background: The Toe Walking Tool is used to highlight the need for further investigation of toe-walking children by a more qualified expert. Such a tool is not yet available within Greek clinical settings. Therefore, the aim of this study was to translate and cross-culturally adapt into Greek the Toe Walking Tool.

Methods: The Toe Walking Tool was translated into Greek according to international guidelines by five pediatric physiotherapists, all fluent in the English language. Fifteen children with toe-walking due to pathologic reasons or idiopathic toe-walking were video-recorded performing the tasks and tests of the tool. Parents answered the questions regarding the children's medical history. Seven pediatric physiotherapists evaluated the 15 children using the video recordings and the parents' answers to complete the tool. Data were analyzed with Fleiss κ, percentage agreement, and χ2 tests. Face and content validity was determined by a group of experts.

Results: The Greek version of the Toe Walking Tool proved to be clinically applicable and user-friendly. The tool was also found to have substantial intrarater reliability, with a Fleiss κ index of 0.73. The percentage agreement between the seven raters was high to very high, ranging from 86% to 100%, and no statistical differences were found between the raters (P < .1).

Conclusions: The Greek version of the Toe Walking Tool demonstrated adequate evidence of interrater reliability and can be used to refer, if required, toe-walking children for further investigation.