Neurodevelopment in preschool idiopathic toe-walkers

Idiopathic toe walking, a differential diagnosis for neurological and orthopaedic disorders, has been associated with neurodevelopmental alterations. Neurodevelopmental assessment at early ages using specific tests may improve management and follow-up of these patients. The aim of our study is to analyse the neurodevelopmental characteristics of preschool idiopathic toe-walkers (ITW) by comparing them to a control group. Our descriptive cross-sectional study compared possible risk factors, neurodevelopmental characteristics, and scores on the Child Neuropsychological Maturity Questionnaire (CUMANIN) between a group of 56 ITWs aged 3-6 and a control group including 40 children. The proportion of males was significantly higher in the ITW group (P=.008). The percentage of patients with a family history (P=.000) and biological risk factors during the perinatal period (P=.032) was also higher in this group. According to the parents’ reports, motor coordination in ITWs was significantly poorer (59%; P=.009). ITWs scored significantly lower on CUMANIN subscales of psychomotricity (P=.001) and memory (P=.001), as well as in verbal development (P=.000), non-verbal development (P=.026), and overall development (P=.004). Foot preference was less marked in the ITW group (P=.047). The neurodevelopmental characteristics of our sample suggest that idiopathic toe walking is a marker of neurodevelopmental impairment. However, further studies are necessary to confirm these findings. La marcha de puntillas idiopática, considerada un diagnóstico de exclusión de alteraciones neurológicas y ortopédicas, se ha relacionado con alteraciones en diversas áreas del desarrollo neuromadurativo. La evaluación del neurodesarrollo en edades tempranas mediante un test específico podría mejorar el seguimiento y el abordaje terapéutico de estos niños. El objetivo de este trabajo es analizar las características neuromadurativas de los andadores de puntillas (AP) de edad preescolar en relación con un grupo control (GC). Mediante un estudio descriptivo transversal se han comparado los posibles factores de riesgo, las características del neurodesarrollo y los resultados del Cuestionario de Madurez Neuropsicológica Infantil (CUMANIN) de un grupo de 56 AP de entre 3 y 6 años con un GC de 40 niños. Entre los AP había un mayor porcentaje de varones (p=0,008) y este grupo presentaba un porcentaje significativamente mayor de antecedentes familiares (p=0,000) y de factores de riesgo biológico durante e