Autism Research Unit, Villa Santa Maria Foundation, Tavernerio, CO, Italy.
School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Autism Res. 2018 Oct;11(10):1404-1415. doi: 10.1002/aur.2009. Epub 2018 Sep 10.
There is increasing evidence that autism spectrum disorder (ASD) subjects have also motor impairments. Toe walking (TW) is a phenomenon that can be found in ASD subjects during gait, even if this condition was found not to be necessarily related only to walking, since these children often also stand and run on their tiptoes. Since persistent TW in ASD subjects may contribute to secondary shortening of the Achilles's tendon, it becomes important to have an assessment tool and/or outcome measure for both the clinical and rehabilitative settings. The aim of this systematic review is to critically evaluate and describe the methods employed to assess toe walking in ASD subjects. The systematic review protocol was previously registered on PROSPERO. We conducted an extensive literature search in PubMed, CINAHL, PsycINFO, The Cochrane Library, and Scopus databases. There were no restrictions on the types of study design eligible for inclusion. Ten studies were included in the systematic review. Risk of bias of the included studies was conducted using the following instruments depending on the study types: STROBE Statement, Cochrane risk of bias tool, and CARE checklist. Almost all the included studies (8/10) proposed a tip-toe behavior (TTB) assessment only during walking. Nine out of ten of the included studies assessed TTB using a qualitative methodology. The results evidenced the heterogeneity of qualitative methods and a lack of a structured quantitative test to assess toe walking in ASD subjects. Autism Res 2018, 11: 1404-1415. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY ABSTRACT: Toe walking (TW) is a phenomenon that can be found during ASD subject's gait. The persistence of this behavior may contribute to secondary Achilles's tendon shortening. In this perspective it becomes important to have an assessment tool and/or outcome measure for both the clinical and rehabilitative settings. The current systematic review aimed to describe the methods employed to assess TW. The results evidenced the lack and the need of a structured quantitative test to assess TW in ASD subjects.
越来越多的证据表明，自闭症谱系障碍（ASD）患者也存在运动障碍。足尖行走（TW）是 ASD 患者在行走过程中可能出现的一种现象，即使这种情况并非一定与行走有关，因为这些孩子在站立和跑步时也经常踮着脚尖。由于 ASD 患者持续 TW 可能导致跟腱继发性缩短，因此在临床和康复环境中都需要一种评估工具和/或结果测量方法。本系统评价的目的是批判性地评估和描述用于评估 ASD 患者 TW 的方法。系统评价方案先前已在 PROSPERO 上注册。我们在 PubMed、CINAHL、PsycINFO、Cochrane 图书馆和 Scopus 数据库中进行了广泛的文献搜索。对纳入研究的类型没有任何限制。本系统评价共纳入 10 项研究。根据研究类型，使用以下工具评估纳入研究的偏倚风险：STROBE 声明、Cochrane 偏倚风险工具和 CARE 清单。几乎所有纳入的研究（10/10）仅在行走时提出了足尖行为（TTB）评估。纳入研究中的 9/10 项使用定性方法评估 TTB。结果表明定性方法存在异质性，缺乏结构化的定量测试来评估 ASD 患者的足尖行走。Autism Res 2018, 11: 1404-1415. © 2018 国际自闭症研究协会，威利期刊，公司。 摘要：足尖行走（TW）是 ASD 患者步态中可能出现的一种现象。这种行为的持续存在可能导致跟腱继发性缩短。从这个角度来看，在临床和康复环境中都需要一种评估工具和/或结果测量方法。本系统评价旨在描述评估 TW 的方法。结果表明，缺乏和需要一种结构化的定量测试来评估 ASD 患者的 TW。
