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Physical activity and quality of life in children with idiopathic toe walking: a cross sectional study
Antoni Caserta1,2, Sarah Reedman3, Prue Morgan4
1Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, 47 - 49 Moorooduc Hwy, Frankston, VIC, 3199, Australia. antoni.caserta@monash.edu.
Insights
Children with idiopathic toe walking (ITW) generally meet physical activity guidelines but struggle with screen time and sleep recommendations. Social functioning in children with ITW was linked to higher physical activity levels.
Area of Science:
- Pediatrics
- Movement Science
- Public Health
Background:
- Idiopathic toe walking (ITW) is a condition where children walk on their toes without a known medical cause.
- Understanding the 24-hour movement behaviors of children with ITW is crucial for guiding interventions.
- Current treatment effectiveness for ITW remains uncertain, necessitating research into associated factors.
Purpose of the Study:
- To assess if children with idiopathic toe walking (ITW) meet Australian 24-hour movement guidelines.
- To identify factors associated with moderate to vigorous physical activity (MVPA) in children with ITW.
Main Methods:
- A cross-sectional study involving 27 children aged 4-14 years with ITW.
- Objective measurement of physical activity, sedentary behavior, and sleep using ActiGraph accelerometers.
- Subjective data collected via the Child Leisure Activities Study Survey (CLASS) and quality of life via the Pediatric Quality of Life Inventory (PedsQL).
Main Results:
- All participants exceeded recommendations for physical activity.
- Only 44% met recommended screen time limits, and 9% met sleep recommendations.
- Higher scores on the Child-Self Report PedsQL social functioning scale were significantly associated with increased physical activity.
Conclusions:
- Children with ITW demonstrate high levels of physical activity, positively associated with social functioning.
- Clinicians should consider the impact of ITW treatments on physical activity, sleep, and social functioning.
- The small sample size necessitates cautious interpretation and limits generalizability of findings.
Objectives:
To 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.
Design:
Cross sectional.
Setting:
Private practice, public health outpatient, community clinics.
Participants:
Children between 4 and 14 years, who toe walked and had no medical conditions known to cause ITW.
Outcome Measures:
Physical 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.
Results:
Twenty-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).
Conclusion:
Participants 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.
