Aims The aim of this study was to gain a consensus for best practice of the assessment and management of children with idiopathic toe walking (ITW) in order to provide a benchmark for practitioners and guide the best consistent care. Methods An established Delphi approach with predetermined steps and degree of agreement based on a standardized protocol was used to determine consensus. The steering group members and Delphi survey participants included members from the British Society of Children's Orthopaedic Surgery (BSCOS) and the Association of Paediatric Chartered Physiotherapists (APCP). The statements included definition, assessment, treatment indications, nonoperative and operative interventions, and outcomes. Descriptive statistics were used for analysis of the Delphi survey results. The AGREE checklist was followed for reporting the results. Results A total of 227 participants (54% APCP and 46% BSCOS members) completed the first round, and 222 participants (98%) completed the second round. Out of 54 proposed statements included in the first round Delphi, 17 reached 'consensus in', no statements reached 'consensus out', and 37 reached 'no consensus'. These 37 statements were then discussed, reworded, amalgamated, or deleted before the second round Delphi of 29 statements. A total of 12 statements reached 'consensus in', four 'consensus out', and 13 'no consensus'. In the final consensus meeting, 13 statements were voted upon. Five were accepted, resulting in a total of 31 approved statements. Conclusion In the aspects of practice where sufficient evidence is not available, a consensus statement can provide a strong body of opinion that acts as a benchmark for excellence in clinical care. This statement can assist clinicians managing children with ITW to ensure consistent and reliable practice, and reduce geographical variability in practice and outcomes. It will enable those treating ITW to share the published consensus document with both carers and patient groups.

中文翻译：

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特发性踮脚尖走路的管理。


目的 本研究的目的是就特发性踮脚尖走路 （ITW） 儿童评估和管理的最佳实践达成共识，以便为从业者提供基准并指导最佳一致的护理。方法 使用基于标准化方案的具有预定步骤和一致程度的已建立 Delphi 方法来确定共识。指导小组成员和 Delphi 调查参与者包括来自英国儿童骨科外科学会 （BSCOS） 和儿科特许物理治疗师协会 （APCP） 的成员。这些陈述包括定义、评估、治疗适应症、非手术和手术干预以及结局。描述性统计用于分析 Delphi 调查结果。按照 AGREE 检查表报告结果。结果 共有 227 名参与者 （54% APCP 和 46% BSCOS 成员） 完成了第一轮，222 名参与者 （98%） 完成了第二轮。在第一轮 Delphi 纳入的 54 份拟议声明中，17 份达成了“共识”，没有达成“共识”，37 份达成了“未达成共识”。然后，这 37 条陈述被讨论、改写、合并或删除，然后进行第二轮 29 项陈述的德尔菲法。共有 12 个声明达成了“共识”，4 个“达成共识”，13 个“未达成共识”。在最终共识会议上，对 13 项声明进行了投票。5 项被接受，总共有 31 项声明获得批准。总结在没有足够证据的实践方面，共识声明可以提供强有力的意见体系，作为临床护理卓越的基准。 该声明可以帮助临床医生管理 ITW 患儿，以确保一致和可靠的实践，并减少实践和结果的地域差异。它将使治疗 ITW 的人能够与护理人员和患者团体共享已发布的共识文件。