Commentary on “Reliability and Validity of the 50-ft Walk Test for Idiopathic Toe Walking”

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“How should I apply this information?”
The percentage of time a child with idiopathic toe walking (ITW) spends walking on his toes may be used as an outcome measure in this population. Because of the limited commercial availability and high cost associated with gold standard gait analysis in a motion analysis laboratory, percentage of toe walking may be recorded as a subjective measure by parent report or clinician observation. The 50-ft walk test (50-FWT) presented in this article is an objective, inexpensive, feasible outcome measure, which, this study demonstrated, is reliable and valid for determining the percentage of toe walking in children ages 6 to 13 years. Clinicians may consider using the 50-FWT in the clinic for assessment, goal setting, and monitoring progress in response to common interventions such as therapeutic exercise, gait training, orthotic intervention, and serial casting.
“What should I be mindful about when applying this information?”
Children with ITW may modify their gait pattern when they are aware of being observed, which may contribute to inaccurate measurements. Clinicians should also be aware of common compensatory gait deviations for toe walking at the trunk, hip, knee, foot, and ankle that are not identified during this test. The 50-FWT should be used in conjunction with other tests and measures such as parent report of toe walking in natural settings, and range of motion, strength, and posture. Future research validating the 50-FWT against caregiver reports of toe walking and 3-dimensional gait analysis may enhance utility of this measure. This test was not found to be reliable in children younger than 6 years and was not assessed in children older than 13 years. Additional research is warranted to determine appropriate outcome measures for gait in children with ITW who present outside the reported age ranges.
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