Evaluation of Postural Control in Children With Idiopathic Toe Walking

The aim of this study is to evaluate postural control in children with idiopathic toe walking using computerized dynamic posturography (Biodex Balance System), which is reported to be a reliable and valid instrument for detecting changes in balance and postural control in the literature.

Study Overview

• Status: Completed
• Conditions: Gait Disorders in Children; Balance; Postural Stability; Postural Control; Idiopathic Toe Walking
• Intervention / Treatment: Other: Biodex Balance System; Other: Balance Error Scoring System (BESS)

Detailed Description

Idiopathic toe walking (ITW) is a term used to describe the condition in which children walk with a toe-toe gait pattern in the absence of any known cause. When the literature is examined, it is reported that a possible neuromechanism of idiopathic toe walking is related to postural disorder and a deterioration of sensory information coming from the proprioceptive, vestibular, visual and / or tactile systems. The most important function of the posture is to maintain the balance during the initiation and continuation of the movement. Postural control regulates maintaining the balance and keeping the center of gravity within the body's stability limits. It includes resistance to gravity forces and mechanical support during movement. Postural control is an integral part of achieving targeted action. Although there are few studies showing the possible relationship, no studies have been found to evaluate postural control by computerized posturography in these children. In this study, we aimed to evaluate postural control in children with idiopathic toe walking using computerized dynamic posturography (Biodex Balance System).

• Study Type: Observational
• Enrollment (Actual): 32

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey
    • Bezmialem Vakif University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 years to 15 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

16 children with idiopathic toe walking aged 6-15 years followed by Bezmialem Vakıf University Department of Orthopedics and Traumatology.

16 healthy volunteers aged 6-15 years will be included in the control group.

Description

Inclusion Criteria:

• Having the diagnosis of idiopathic toe walking
• No contact with the heel in the initial contact phase of the gait
• Presence of bilateral toe walking gait
• Normal neurological and orthopedic examination results
• Achievement of independent walking before 18 months
• Absence of pervasive developmental disorder or autism

Exclusion Criteria:

• A history of BoNT-A or surgery in the last 6 months
• Presence of leg length discrepancy

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Children with idiopathic toe walking; After the demographic information, developmental history and gait information were recorded with the Evaluation Form, clinical evaluation was performed; bilateral lower extremity range of motion, flexibility, leg length measurement, and muscle strength measurement and muscular endurance tests (abdominal, back and lower extremity) will be performed. For the clinical evaluation of postural control, the Modified Balance Error Scoring System (BESS) and the Biodex Balance System for computerized evaluation will be used.	Other: Biodex Balance System; For the computerized evaluation of postural control, Biodex Balance System will be used.; Other: Balance Error Scoring System (BESS); For the clinical evaluation of postural control, the Modified Balance Error Scoring System (BESS) will be used.
Healthy children; After the demographic information, developmental history and gait information were recorded with the Evaluation Form, clinical evaluation was performed; bilateral lower extremity range of motion, flexibility, leg length measurement, and muscle strength measurement and muscular endurance tests (abdominal, back and lower extremity) will be performed. For the clinical evaluation of postural control, the Modified Balance Error Scoring System (BESS) and the Biodex Balance System for computerized evaluation will be used.	Other: Biodex Balance System; For the computerized evaluation of postural control, Biodex Balance System will be used.; Other: Balance Error Scoring System (BESS); For the clinical evaluation of postural control, the Modified Balance Error Scoring System (BESS) will be used.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postural control-postural stability	Computerized test of postural stability with Biodex Balance System	1 day
Postural control-limits of stability	Computerized test of limits of stability with Biodex Balance System	1 day
Postural control-sensory integration	Computerized test of sensory integration with Biodex Balance System	1 day
Balance Error Scorring System-BESS	Clinical evaluation of postural control	1 day

Collaborators and Investigators

• Sponsor: Bezmialem Vakif University
• Investigators: Study Director: Hulya N Gurses, Prof., Bezmialem Vakif University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2019
• Primary Completion (Actual): March 1, 2022
• Study Completion (Actual): May 1, 2022

Study Registration Dates

• First Submitted: December 13, 2019
• First Submitted That Met QC Criteria: December 13, 2019
• First Posted (Actual): December 16, 2019

Study Record Updates

• Last Update Posted (Actual): July 20, 2022
• Last Update Submitted That Met QC Criteria: July 19, 2022
• Last Verified: July 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: DT-02

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No