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Validation of Parental Reports in Assessing Idiopathic Toe Walking Using Quantitative In-Shoe Device Measurements
Logan Morrison1,2, Susan Sienko1, Mark McMulkin3
1Shriners Children's Portland, Portland, OR.
Journal of Pediatric Orthopedics
|March 12, 2025
Summary
Parental reports on childhood toe walking are fairly accurate for clinical use. However, in-shoe devices offer more objective data for assessing idiopathic toe walking (ITWp) and guiding treatment.
Area of Science:
- Pediatric Orthopedics
- Biomechanical Engineering
- Clinical Diagnostics
Background:
- Idiopathic toe walking (ITWp) affects 5-24% of children.
- Parental reports are crucial for ITWp assessment but can be unreliable.
- Objective validation of parental reports is needed.
Purpose of the Study:
- To validate parental reports of toe walking frequency against objective in-shoe device measurements.
- To assess the reliability of parental recall in ITWp diagnosis.
Main Methods:
- A multicenter study involving 20 children with persistent ITWp.
- Parents reported toe walking frequency on a 6-point scale.
- Children wore NURVV/RUN insoles for 7 days to record foot strike patterns.
- Agreement was analyzed using weighted Kappa statistics.
Main Results:
- Substantial agreement (k=0.688) was found for combined forefoot and midfoot contact.
- Fair agreement (k=0.381) was observed for isolated forefoot contact.
- Children with ITWp showed 61.7% forefoot, 15.3% midfoot, and 22.8% hindfoot contact.
Conclusions:
- Parental reports demonstrate relative accuracy for ITWp clinical management.
- Quantitative in-shoe devices provide objective data for ITWp assessment.
- In-shoe technology can enhance clinical decision-making and outcomes evaluation for ITWp.
