Dataset Information

American and Australian family experiences while receiving a diagnosis or having treatment for idiopathic toe walking: a qualitative study.

ABSTRACT:

Objective

To understand parent journeys while navigating diagnosis, assessment or treatment of their children with idiopathic toe walking (ITW).

Design

Mixed methods qualitative study: analyses of survey data from the measure of processes of care-20 (MPOC-20) and semistructured interviews were analysed with an interpretative phenomenological analysis approach. Trustworthiness of data was achieved through member checking, researcher triangulation, reflexivity and transferability and comparison with the MPOC-20 results.

Setting

USA and Australia.

Participants

Parents of children diagnosed with ITW who had seen more than one health professional during their care and lived in Australia or the USA.

Results

Ten parents of children aged between 3 and 13 years and diagnosed with ITW participated. Parents described complex themes relating to their journeys. The themes relating to their journeys were: (1) riding the rollercoaster of diagnosis; (2) navigating the treatment options and (3) supporting parents in the journey. Each theme was supported by parent quotes about their experiences. Challenges were not localised to one country, in spite of vastly different healthcare systems.

Conclusions

These findings create opportunities for an international approach to education, treatment recommendations and outcome measures to improve patient and parent experiences. Health professionals should consider the impact on parents in navigating between health professionals when provided with a diagnosis which can have variable outcomes and varied treatment options.

SUBMITTER: Williams C

PROVIDER: S-EPMC7470490 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

American and Australian family experiences while receiving a diagnosis or having treatment for idiopathic toe walking: a qualitative study.

Williams Cylie C Robson Kristy K Pacey Verity V Gray Kelly K

BMJ open 20200902 9

<h4>Objective</h4>To understand parent journeys while navigating diagnosis, assessment or treatment of their children with idiopathic toe walking (ITW).<h4>Design</h4>Mixed methods qualitative study: analyses of survey data from the measure of processes of care-20 (MPOC-20) and semistructured interviews were analysed with an interpretative phenomenological analysis approach. Trustworthiness of data was achieved through member checking, researcher triangulation, reflexivity and transferability an ...[more]

PMID: 32878753

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Project description:ObjectivesTo determine if children with idiopathic toe walking (ITW) reach Australian 24-hour movement guidelines. Additional objectives were to identify any factors associated with moderate to vigorous physical activity time of children with ITW.DesignCross sectional.SettingPrivate practice, public health outpatient, community clinics.ParticipantsChildren between 4 and 14 years, who toe walked and had no medical conditions known to cause ITW.Outcome measuresPhysical activity intensity, sedentary behaviour and sleep data were collected via an ActiGraph. Physical activity level intensity data were triangulated with the Child Leisure Activities Study Survey (CLASS) to highlight the subjective nature of parent-reported measures. Health related quality of life information was collected using the Parent-Proxy and Child-Self Report Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scale. Regression analyses were used to explore individual factors associated with moderate to vigorous physical activity.ResultsTwenty-seven participants, 17(63%) male, age mean = 6.62 (SD = 2.29) years, provided information on physical activity (CLASS n = 18, ActiGraph n = 22), physical functioning and psychosocial functioning domains on the PedsQL (Parent-Proxy n = 25, Child n = 22). All participants exceeded Australian recommendations for physical activity, 44% (8/18) met recommended screen time amounts, and two (9%) met recommended sleep times. The Child-Self Report PedsQL scale score of social functioning was the only factor associated with an increase in physical activity (Coef = 0.48, 95%CI = 0.09 to 0.87, p = 0.019).ConclusionParticipants achieved high levels of daily moderate to vigorous physical activity, and this was associated with social functioning. Given current uncertainty regarding benefits and effectiveness of treatment choices for children who have ITW, these findings should encourage clinicians to consider how their treatment recommendations interact with the PA level and sleep of children with ITW. Any treatment choice should also be implemented with consideration of how it may impact social functioning. This study had a small sample size therefore results should be cautiously interpreted and not generalised to all children with ITW.

Project description:During typical human walking, the metatarsophalangeal joints undergo extension/flexion, which we term toe joint articulation. This toe joint articulation impacts locomotor performance, as evidenced by prior studies on prostheses, footwear, sports and humanoid robots. However, a knowledge gap exists in our understanding of how individual toe properties (e.g. shape, joint stiffness) affect bipedal locomotion. To address this gap, we designed and built a pair of adjustable foot prostheses that enabled us to independently vary different toe properties, across a broad range of physiological and non-physiological values. We then characterized the effects of varying toe joint stiffness across a range of different ankle joint stiffness conditions, and the effects of varying toe shape on walking biomechanics. Ten able-bodied individuals walked on a treadmill with prostheses mounted bilaterally underneath simulator boots (which immobilized their biological ankles). We collected motion capture and ground reaction force data, then computed joint kinematics and kinetics, and center-of-mass (COM) power and work. To our surprise, we found that varying toe joint stiffness affected COM Push-off dynamics during walking as much as, or in some cases even more than, varying ankle joint stiffness. Increasing toe joint stiffness increased COM Push-off work by up to 48% (6 J), and prosthetic anklefoot Push-off work by up to 181% (12 J). In contrast, large changes in toe shape had little effect on gait. This study brings attention to the toes, an aspect of prosthetic and robotic foot design that is often overlooked or overshadowed by design of the ankle. Optimizing toe joint stiffness in assistive and robotic devices (e.g. prostheses, exoskeletons, robot feet) may provide a complementary means of enhancing Push-off or other aspects of locomotor performance, in conjunction with the more conventional approach of augmenting ankle dynamics. Future studies are needed to isolate the effects of additional toe properties (e.g. toe length).

Dataset Information

American and Australian family experiences while receiving a diagnosis or having treatment for idiopathic toe walking: a qualitative study.

Objective

Design

Setting

Participants

Results

Conclusions

Publications

American and Australian family experiences while receiving a diagnosis or having treatment for idiopathic toe walking: a qualitative study.

Similar Datasets

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