Effect of a nonsurgical treatment program on the gait pattern of idiopathic toe walking: a case report

Clinical gait analysis is the accepted “gold standard” for evaluating an individual’s walking pattern. However, in certain conditions such as idiopathic toe walking (ITW), the degree of voluntary control that a subject may elicit upon their walking pattern in a gait laboratory may not truly reflect their gait during daily activities. Therefore, a battery-powered, wireless data acquisition system was developed to record daily walking patterns to assist in the assessment of treatment outcomes in this patient population. The device was developed to be small (30×50×12 mm3), light-weight (15 g), easy to install, reliable, and consumed little power. It could be mounted across the laces of the shoe, while forces and walking activities were recorded to investigate the percentage of toe walking during the assessment. Laboratory tests were performed and preliminary clinical trials at a gait laboratory were done on six normal gait walkers. These volunteers also try to walk on their toes to simulate the toe walking at the gait laboratory. The system was able to track the gait pattern and determine the percentage of toe walking relative to normal gait. Three boys and one girl were diagnosed with ITW then participated into this study. A total of 4 sets thirty-three 10 min data sessions (5.5 h) were collected outside the laboratory. The results showed that the test subjects walked on their toes 70±4% of the total walking time, which was higher than that they performed 64±5% at the gait laboratory. This preliminary study shows promising results that the system should be able to use for clinical assessment and evaluation of children with ITW.

Download Full-text

Do children with attention deficit and hyperactivity disorder (ADHD) have a different gait pattern? Relationship between idiopathic toe-walking and ADHD

Anales de Pediatría (English Edition) ◽

10.1016/j.anpede.2017.01.011 ◽

2018 ◽

Vol 88 (4) ◽

pp. 191-195

Author(s):

Víctor Soto Insuga ◽

Beatriz Moreno Vinués ◽

Rebeca Losada del Pozo ◽

María Rodrigo Moreno ◽

Marta Martínez González ◽

...

Keyword(s):

Attention Deficit ◽

Gait Pattern ◽

Hyperactivity Disorder ◽

Idiopathic Toe Walking ◽

Toe Walking

Download Full-text

The 3-Step Pyramid Insole Treatment Concept for Idiopathic Toe Walking

Foot & Ankle Specialist ◽

10.1177/1938640016669794 ◽

2016 ◽

Vol 9 (6) ◽

pp. 543-549 ◽

Cited By ~ 1

Author(s):

David Pomarino ◽

Juliana Ramírez-Llamas ◽

Stephan Martin ◽

Andrea Pomarino

Keyword(s):

Physical Therapy ◽

Wide Spectrum ◽

Treatment Options ◽

Gait Pattern ◽

Treatment Modalities ◽

Treatment Concept ◽

Therapeutic Modalities ◽

Idiopathic Toe Walking ◽

Effective Option ◽

Toe Walking

The idiopathic toe walking (ITW) gait pattern is characterized in children for walking since the beginning on their first steps on the forefoot; however, these children are able to support their whole foot on the ground. ITW can only be diagnosed in the absence of any orthopaedic or neurological condition known to cause tiptoe walking. The aim of this article is to review other references and provide an outline of the different treatment options, including the 3-step-pyramid insole treatment concept for children with ITW. Methods. Fifty-four articles in English, German, and Spanish were reviewed. There were comparative, retrospective or case studies, classifications or literature reviews and they were divided according with these categories. All the literature reviewed was published between 2000 and 2015. Results. There are some studies that proved the 3-step pyramid insole treatment concept as an effective option compared with other therapeutic modalities such as physical therapy, casting, botolinum toxin type A (BTX), and surgery. Conclusion. There is a wide spectrum regarding the therapeutic options for children with ITW, from physical therapy to surgery options. However, any of these treatment modalities have been reported to be fully successful for the whole toe walking population. Some procedures seem to have achieved faster results or seem to have longer lasting effects. Therefore, further research on the causes of ITW is recommended. Levels of Evidence: Therapeutic, Level II: Systematic review, prospective, comparative

Download Full-text

The Dynamic Baropodometric Profile of Children with Idiopathic Toe-Walking

Journal of the American Podiatric Medical Association ◽

10.7547/17-084 ◽

2019 ◽

Vol 109 (1) ◽

pp. 50-56 ◽

Cited By ~ 1

Author(s):

Patricia Martín-Casas ◽

Alfonso Meneses-Monroy ◽

Juan Vicente Beneit-Montesinos ◽

María de los Ángeles Atín-Arratibel ◽

Gustavo Plaza-Manzano ◽

...

Keyword(s):

Medical Condition ◽

Gait Pattern ◽

Walking Gait ◽

Plantar Pressures ◽

Pressure Distributions ◽

Foot Progression Angle ◽

Idiopathic Toe Walking ◽

Long Term Impact ◽

Peak Pressures ◽

Toe Walking

Background: Idiopathic toe-walking (ITW) gait may present in children older than 3 years and in the absence of a medical condition known to cause or be associated with toe-walking gait. It is unknown how this gait type changes pressure distribution in the growing foot. We sought to determine whether children with ITW gait exhibit different plantar pressures and temporal gait features than typically developing children. Methods: Children aged 3 to 6 years were recruited who had either a typical heel-toe gait pattern or a diagnosis of ITW. The ITW diagnosis was reported by the parent/caregiver and confirmed through history and physical examination. Temporal gait measures, peak pressures, and impulse percentages were measured. A minimum of ten unshod footprints were collected. Data were compared with unpaired t tests. Results: The study included 40 children with typical gait and 56 with ITW gait. The ITW group displayed lower peak pressures at the hallux, midfoot, and hindfoot (P < .05) and higher and lower pressure impulse percentages at the forefoot (P < .001) and hindfoot (P < .001), respectively. The ITW group spent a higher percentage of contact time at all areas of the forefoot and less at the midfoot and rearfoot (P < .05). There were no significant differences in total step duration and foot progression angle between groups (P > .05). Conclusions: There were differences in pressure distributions between groups. Understanding these differences may help us better understand the compensations or potential long-term impact that ITW gait may have on a young child's foot. Podiatric physicians may also consider the use of this equipment in the clinical setting to measure outcomes after treatment for ITW.

Download Full-text