EXPLORING THE RELATIONSHIP BETWEEN TWO RANGE OF MOTION OUTCOMES AND GAIT PARAMETERS IN CHILDREN WITH IDIOPATHIC TOE WALKING.

The hallmark of idiopathic toe walking (ITW) is persistent toe-toe gait. Compared to peers with typical development (TD), children with ITW often exhibit decreased dorsiflexion range of motion (DF-ROM) and differences in a variety of spatiotemporal gait parameters (STPs). This study explores the concurrent validity between two ROM assessments (goniometry and the weight bearing lunge test (WBLT)) and examine their relationships with STP gait variables in children with ITW. STPs were assessed using a ZenoTM Walkway. Spearman rho correlations and the Bland-Altman approach were used to examine relationships among the ROM approaches and STPs. A strong, significant correlation was found between the WBLT and goniometry. The 95% Limits of Agreement were calculated to be -8.72° to 16.18° (mean bias = 3.73°). There was a moderate to strong relationship between the DF-ROM and step time, stance time, and single stance time. Two common methods to assess DF-ROM do not appear to be interchangeable. Given that the WBLT may suffer from a floor effect and produce ROM scores that do not correlate as strongly with gait variables compared to those observed with goniometry, goniometry may be the preferred method for assessing ROM in children with ITW. However, given the small sample size, additional research is needed. Physical therapists working with children with ITW should consider assessing DF-ROM using traditional goniometry rather than the lunge test. While more research is needed, our results suggest that DF-ROM may be related to several STPs in children with ITW.