Toddle temporal-spatial deviation index: Assessment of pediatric gait

• Introduces the Toddle TDI, a gait index for clinical and research use.
• Quantifies gait parameters’ deviation from normal in 18–22 month-old children.
• Sensitive and specific to gross motor function.

This research aims to develop a gait index for use in the pediatric clinic as well as research, that quantifies gait deviation in 18–22 month-old children: the Toddle Temporal-spatial Deviation Index (Toddle TDI). 81 preterm children (≤32 weeks) with very-low-birth-weights (≤1500 g) and 42 full-term TD children aged 18–22 months, adjusted for prematurity, walked on a pressure-sensitive mat. Preterm children were administered the Bayley Scales of Infant Development—3rd Edition (BSID-III). Principle component analysis of TD children’s temporal-spatial gait parameters quantified raw gait deviation from typical, normalized to an average(standard deviation) Toddle TDI score of 100(10), and calculated for all participants. The Toddle TDI was significantly lower for preterm versus TD children (86 vs. 100, p = 0.003), and lower in preterm children with <85 vs. ≥85 BSID-III motor composite scores (66 vs. 89, p = 0.004). The Toddle TDI, which by design plateaus at typical average (BSID-III gross motor 8–12), correlated with BSID-III gross motor (r = 0.60, p < 0.001) and not fine motor (r = 0.08, p = 0.65) in preterm children with gross motor scores ≤8, suggesting sensitivity to gross motor development. The Toddle TDI demonstrated sensitivity and specificity to gross motor function in very-low-birth-weight preterm children aged 18–22 months, and has been potential as an easily-administered, revealing clinical gait metric.