*Colegio Público de Educación Especial María Soriano,Ayuntamiento de Madrid, Madrid, Spain.
†Departamento de Radiología, Rehabilitación y Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
J Am Podiatr Med Assoc. 2023 Sep-Oct;113(5). doi: 10.7547/21-092.
The Toe Walking Tool (TWT) was developed in Australia as a valid and reliable screening tool for children who toe-walk. However, psychometric properties of the Spanish version of the TWT have not been studied. The aim of this study was to assess psychometric properties and clinical usefulness of the Spanish version of the TWT.
A cross-sectional study was conducted. Twelve children were assessed with the TWT. Intrarater and interrater reliability and agreement were calculated using the intraclass correlation coefficient (ICC) and the Fleiss kappa method for multiple raters. Internal consistency and construct validity were assessed with the Kuder-Richardson formula 20 coefficient and known-group methods, respectively. Sensitivity and specificity were analyzed using the receiver operating characteristic curve. The Content Validity Index was calculated to determine clinical usefulness.
An excellent intrarater (ICC = 1) and interrater reliability (ICC = 0.8), moderate interrater agreement (Fleiss kappa, 0.6), strong internal consistency (Kuder-Richardson formula 20 coefficient, 0.86), and very good construct validity were found. Sensitivity and specificity results were appropriate (area under the curve, 0.845). The Content Validity Index was 0.906, suggesting high usefulness.
The Spanish version of the TWT was found to be a valid, reliable and useful screening tool for children who toe-walk, providing evidence for its recommendation.
足尖行走工具（TWT）是在澳大利亚开发的，作为一种用于评估足尖行走儿童的有效且可靠的筛查工具。然而，尚未对 TWT 的西班牙语版本进行心理测量学特性研究。本研究旨在评估 TWT 西班牙语版本的心理测量学特性和临床实用性。
进行了一项横断面研究。对 12 名儿童进行 TWT 评估。使用组内相关系数（ICC）和多评估者的 Fleiss kappa 方法计算了内部和组间的可靠性和一致性。使用 Kuder-Richardson 公式 20 系数和已知组方法分别评估了内部一致性和结构有效性。使用接收者操作特征曲线分析了敏感性和特异性。计算内容有效性指数以确定临床实用性。
发现内部（ICC=1）和组间（ICC=0.8）具有极好的可靠性、中度的组间一致性（Fleiss kappa，0.6）、较强的内部一致性（Kuder-Richardson 公式 20 系数，0.86）和非常好的结构有效性。敏感性和特异性结果适当（曲线下面积，0.845）。内容有效性指数为 0.906，表明非常有用。
TWT 的西班牙语版本被认为是一种用于评估足尖行走儿童的有效、可靠且有用的筛查工具，为其推荐提供了证据。
