Is in-toing gait physiological in children? : Results of a large cohort study in 5910 healthy (pre-) school children

Verch, Ronald; Hirschmüller, Anja; Müller, Juliane; Baur, Heiner; Mayer, Frank; Müller, Steffen (2018). Is in-toing gait physiological in children? : Results of a large cohort study in 5910 healthy (pre-) school children Gait Posture, 66, pp. 70-75. Elsevier 10.1016/j.gaitpost.2018.08.019

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Background In-toeing is a major concern of many parents presenting their children to pediatric orthopedists. Foot progression angle (FPA) quantifies the rotation of the foot’s longitudinal axis during gait, with negative values describing in-toeing and positive values describing out-toeing. Although it has been shown that the FPA changes over the course of a child’s development, reference values for the normal FPA-range are lacking. Research question This study aimed to establish reference values in 1–14 year old healthy children and to implement FPA-percentile curves for daily clinical use. Methods 5910 healthy children performed at least 3 repetitions of barefoot walking over an instrumented walkway using a pressure measurement platform. The FPA [°] was extracted and analyzed by age and gender (mean ± standard deviation; median with percentiles, MANOVA (age, gender) and Wilcoxon-Signed-Rank test for intra-individual side differences (α = 0.05). Results FPA maximum was observed in 2-year-old children and diminished significant until the age of 4 to moderate out-toeing. For ages 5–14, no statistically significant differences in FPA values were present (p > 0.05). MANOVA confirmed age (p < 0.001) and gender (p < 0.001) as significant FPA influencing factors, without combined effect (p > 0.05). In every age group, right feet showed significantly greater out-toeing (p < 0.05). Significance Percentile values indicate a wide FPA range in children. FPA development in young children shows a spontaneous shift towards moderate external rotation (age 2–4), whereby in-toeing ≤ 1–5° can be present, but can return to normal. Bilateral in-toeing after the age of four and unilateral in-toeing after the age of seven should be monitored. Keywords Foot progression angle ; Children ; In-toeing ; Out-toeing ; Gait

Item Type:	Journal Article (Original Article)
Division/Institute:	School of Health Professions School of Health Professions > Physiotherapy School of Health Professions > Physiotherapy > Neuromuscular Control
Name:	Verch, Ronald; Hirschmüller, Anja; Müller, Juliane; Baur, Heiner0000-0002-4780-225X; Mayer, Frank and Müller, Steffen
ISSN:	0966-6362
Publisher:	Elsevier
Language:	English
Submitter:	Service Account
Date Deposited:	29 Oct 2019 11:42
Last Modified:	25 May 2021 14:58
Publisher DOI:	10.1016/j.gaitpost.2018.08.019
ARBOR DOI:	10.24451/arbor.6763
URI:	https://arbor.bfh.ch/id/eprint/6763