School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia.
School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Acta Paediatr. 2023 Aug;112(8):1620-1632. doi: 10.1111/apa.16821. Epub 2023 May 23.
Idiopathic toe walking (ITW) is a diagnosis for children who toe walk without another diagnosis known to cause toe walking. Recent research has suggested that children with ITW may have mild motor planning challenges and sensory processing differences. The primary aim of this systematic review was to determine whether children diagnosed with ITW have differences in their sensory processing compared to typically developing children. Secondary aims included determining how sensory processing was assessed in this population and documenting the broad clinometric and psychometric properties of any assessment tools.
MEDLINE, CINAHL, AMED and Embase were searched for relevant literature in English. Studies were eligible for inclusion if they described children aged 3 and 18 with idiopathic toe walking and reported a sensory processing domain.
Twelve articles met the inclusion criteria; however, only two papers included data permitting meta-analysis. Meta-analyses of vibration perception threshold using a random effect model were not significant (p = 0.31). Other data were synthesised by narrative and showed a high heterogeneity across multiple sensory processing domains.
This study highlights that despite children with ITW often conceptualised as possessing sensory processing challenges, there is little evidence supporting this theory. Further research on sensory processing in children with this gait pattern is necessary.
特发性趾行（ITW）是一种诊断，用于描述那些没有其他已知原因导致趾行的儿童。最近的研究表明，ITW 患儿可能存在轻微的运动规划挑战和感觉处理差异。本系统评价的主要目的是确定诊断为 ITW 的儿童与正常发育儿童相比，其感觉处理是否存在差异。次要目标包括确定该人群中如何评估感觉处理，并记录任何评估工具的广泛临床计量和心理计量特性。
在英文数据库 MEDLINE、CINAHL、AMED 和 Embase 中搜索相关文献。如果研究描述了年龄在 3 至 18 岁的特发性趾行儿童，并报告了感觉处理领域的情况，则符合纳入标准。
符合纳入标准的文章有 12 篇，但仅有 2 篇文章包含了可进行荟萃分析的数据。使用随机效应模型进行振动知觉阈值的荟萃分析没有统计学意义（p=0.31）。其他数据则通过叙述性综合进行分析，显示出多个感觉处理领域的高度异质性。
本研究强调，尽管 ITW 患儿通常被认为存在感觉处理挑战，但几乎没有证据支持这一理论。需要对具有这种步态模式的儿童的感觉处理进行进一步研究。
