Evaluation of Postural Control in Children With Idiopathic Toe Walking

Study Overview
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Brief Summary
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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.

Detailed Description
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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).

Official Title
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Evaluation of Postural Control in Children With Idiopathic Toe Walking

Conditions
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Idiopathic Toe Walking, Gait Disorders in Children, Postural Control, Postural Stability, Balance

Intervention / Treatment
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* Other: Biodex Balance System
* Other: Balance Error Scoring System (BESS)


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Children with idiopathic toe walking<br>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<br>* For the computerized evaluation of postural control, Biodex Balance System will be used.<br>Other: Balance Error Scoring System (BESS)<br>* For the clinical evaluation of postural control, the Modified Balance Error Scoring System (BESS) will be used.<br>|
| Healthy children<br>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<br>* For the computerized evaluation of postural control, Biodex Balance System will be used.<br>Other: Balance Error Scoring System (BESS)<br>* For the clinical evaluation of postural control, the Modified Balance Error Scoring System (BESS) will be used.<br>|

What is the study measuring?
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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 |