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Published on: August 30, 2016
Assessing dynamic stability in children with idiopathic toe walking during overground walking
Michelle Gwerder1, Michèle Widmer2, Olivia Schären3
1Laboratory for Movement Biomechanics, ETH Zürich, Zürich, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
Clinical Biomechanics (Bristol, Avon)
|February 21, 2025
Summary
Children with idiopathic toe walking exhibit poorer dynamic stability, using a forward-falling strategy. This study highlights the clinical relevance of assessing margin of stability and whole-body angular momentum for diagnosis and monitoring interventions.
Area of Science:
- Pediatric Orthopedics
- Biomechanics
- Motor Control
Background:
- Idiopathic toe walking (ITW) in children is associated with reduced ankle mobility, impaired balance, and motor control deficits.
- Current diagnostic and monitoring methods for ITW require improvement for holistic assessment.
- Dynamic stability assessment is crucial for understanding ITW and guiding interventions.
Purpose of the Study:
- To assess dynamic stability in children with ITW using margin of stability (MoS) and whole-body angular momentum (WBAM).
- To evaluate the clinical relevance of these dynamic stability measures in ITW.
- To investigate the movement strategies employed by children with ITW.
Main Methods:
- A retrospective cross-sectional study involving 35 children with ITW and 20 typically developing controls.
- Clinical gait analysis including spatiotemporal parameters, MoS, WBAM, and GaitSD.
- Statistical analysis using Student t-tests with adjustments for multiple comparisons.
Main Results:
- Children with ITW demonstrated a significantly shorter anterior margin of stability (ES=1.29).
- Idiopathic toe walkers exhibited significantly larger whole-body angular momentum in the coronal plane (ES=0.90).
- No other significant differences in dynamic stability measures were found.
Conclusions:
- Children with ITW adopt an immature, forward-falling movement strategy, likely to aid energy absorption.
- Dynamic stability measures offer insights into balance capabilities and walking strategies in ITW.
- These measures hold potential for improving ITW diagnosis and quantifying therapeutic outcomes.
