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Idiopathic toe walker

Jacob T Cox, David M Gullotti, Christopher A Mecoli, Arash H Lahouti, Jemima Albayda, Julie Paik, Cheilonda Johnson, Sonye K Danoff, Andrew L Mammen, Lisa Christopher-Stine
Mechanic's hands is a well-characterized manifestation of select idiopathic inflammatory myopathy (IIM) syndromes. Less well characterized is the hyperkeratosis of the toes and plantar surface of the feet that can also accompany these disorders. We aim to describe common pedal signs in the context of IIM, and suggest that it may be another key feature in the presentation of these syndromes. A cohort of 2145 myositis patient charts gathered since 2003 were retrospectively reviewed using the key search terms "mechanic's feet" and/or "mechanic's foot...
July 2017: Clinical Rheumatology
Mark R Sinclair, Allison A Lind, Joshua Q Knowlton
The aim of this study was to determine whether persistent idiopathic toe walking leads to compensatory skeletal changes in the pediatric foot and ankle. Foot radiographs of children diagnosed with idiopathic toe walking and sex-matched and age-matched controls were retrospectively reviewed. Five blinded providers assessed the foot radiographs for skeletal changes to the ankle. The relationship between each measure and toe-walking status was examined. Providers observed radiographic evidence of skeletal changes of the talus in idiopathic toe walkers compared with controls, suggesting that persistent toe walking impacts the skeletal development of the talus...
January 2018: Journal of Pediatric Orthopedics. Part B
David Pomarino, Juliana Ramírez Llamas, Stephan Martin, Andrea Pomarino
PURPOSE: The main objective of this review is to gather the information available about idiopathic toe walking (ITW), its prevalence and classification, and possible therapeutic approaches. In addition, this review aims to clarify the differences between idiopathic toe walkers and tiptoe walkers with underlying neurological or muscle deficiency as primary conditions. Understanding its causes and learning to make a differential diagnosis will help determine the adequate therapeutic approach...
August 2017: Foot & Ankle Specialist
David Pomarino, Juliana Ramírez Llamas, Andrea Pomarino
UNLABELLED: Current literature is inconsistent concerning the causes and the frequency of idiopathic toe walking (ITW). Available studies vary widely in their results. The aim of this study is to supply gender-related data particularly regarding the genetic influence on toe walking. Methods The ITW patterns of 836 children were recorded and analyzed during a period of 4 years. Questionnaires and clinical measurements were evaluated along with clinical tests, assessing the occurrence and severity of toe walking...
October 2016: Foot & Ankle Specialist
Heli Sätilä, Anneli Beilmann, Päivi Olsén, Heli Helander, Mari Eskelinen, Heini Huhtala
Objective We conducted a randomized controlled trial to evaluate whether a combination of repeated botulinum toxin A (BTX-A) and conservative treatment is more effective in decreasing toe-walking than conservative treatment alone at 24 months follow-up. Patients and Methods Children between 2 and 9 years of age were randomized either into the conservative (CO) or botulinum treatment (BTX) group. The treatment in the CO group consisted of firm shoes, night splints, a home stretching program and physiotherapy...
June 2016: Neuropediatrics
P Martín-Casas, R Ballestero-Pérez, A Meneses-Monroy, J V Beneit-Montesinos, M A Atín-Arratibel, J A Portellano-Pérez
INTRODUCTION: 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. METHOD: 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 to 6 and a control group including 40 children...
April 14, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Mark L McMulkin, Andi B Gordon, Bryan J Tompkins, Paul M Caskey, Glen O Baird
Toe walking is a common gait deviation which in the absence of a known cause is termed idiopathic toe walking. Surgical treatment in the presence of a triceps surae contracture includes tendo-Achilles or gastrocnemius/soleus recession and has been shown to be effective in improving kinematic outcomes at a one year follow up. The purpose of this study was to assess longer term kinematic and kinetic outcomes of children with idiopathic toe walking treated surgically for gastrocnemius/soleus contractures. Eight subjects with a diagnosis of idiopathic toe walking who had surgical lengthening of the gastrocnemius/soleus and had previous motion analysis laboratory studies pre-operative and 1 year post-operative, returned for a motion analysis laboratory study greater than 5 years since surgery...
February 2016: Gait & Posture
Heli Sätilä, Essi Marttinen, Helena Mäenpää
Idiopathic toe walking refers to continual or intermittent symmetrical gait pattern, in which the normal heel strike is lacking and the weight of the gait is on the ball of the foot. Many toe walkers are able to walk normally if they so wish. Diagnosis is established by excluding any neurological, neuromuscular, structural and orthopedic causes. Toe walkers often exhibit problems in sensory integration. Idiopathic toe walking is considered a benign phenomenon, usually self-limiting before school age, but upon becoming prolonged it may cause physical and social handicap for the child...
2015: Duodecim; Lääketieteellinen Aikakauskirja
Emidio E Pistilli, Tracy Rice, Paola Pergami, Mary Beth Mandich
BACKGROUND: Idiopathic toe walking is characterized by persistent toe walking in the absence of clinically diagnosed neuromuscular disease. Treatment options in children diagnosed with idiopathic toe walking include: observation, physical therapy, serial casting, or Achilles tendon (heel cord) lengthening surgery. OBJECTIVE: In this case report, we present a non-invasive serial casting protocol to treat severe and persistent toe walking in an 18-month old child, diagnosed as an idiopathic toe walker following neurological examination...
2014: NeuroRehabilitation
Pähr Engström, Kristina Tedroff
BACKGROUND: Children walking on their toes instead of with a typical gait, without evidence of an underlying medical condition, are defined as idiopathic toe-walkers. The prevalence of idiopathic toe-walking is unknown. METHODS: A cross-sectional prevalence study of 5.5-year-old children (n = 1436) living in Blekinge County, Sweden, was performed at the regular 5.5-year visit to the local child welfare center. Children were assessed for a history of toe-walking or whether they still walked on their toes...
August 2012: Pediatrics
Z Péjin, S Pannier, C Glorion
Toe walking is a frequent situation for a clinic in pediatric orthopedic. It is, in most cases, an idiopathic trouble. Neurologic examination is very important to recognize spastic diplegia or neuromuscular disease. A contracture of the triceps can occur and will require a specific treatment from physiotherapy to surgery. A psychological approach is sometimes necessary.
September 2010: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Cylie M Williams, Paul Tinley, Michael Curtin
BACKGROUND: The diagnosis of idiopathic toe walking (ITW) is achieved by the exclusion of all medical causes associated with toe walking. In order to identify children with this gait type, an online Toe Walking Tool questionnaire was developed that utilized questions to identify healthy idiopathic toe walkers and excluded those who toe walk as a result of a medical condition. METHOD: A Delphi panel process was conducted to establish the relevance and validity of the questions...
October 2010: Gait & Posture
Matthew C Solan, Julie Kohls-Gatzoulis, Michael M Stephens
Toe walking is a common feature in immature gait and is considered normal up to 3 years of age. As walking ability improves, initial contact is made with the heel. Toe-walkers will stand out as different once heel-strike is achieved by most of their peers. This difference gives rise to parental concern. Therefore toe-walkers are often referred at 3 years of age. This article examines the evidence for the management of children who have idiopathic toe walking and reviews the literature on surgery for the lengthening of a calf contracture...
June 2010: Foot and Ankle Clinics
Gita Pendharkar, Daniel T H Lai, Rezaul K Begg
Toe walking is commonly seen in children with neurological symptoms such as cerebral palsy. However idiopathic toe walking (ITW) in children is considered to be habitual. ITW children are categorized as toe walkers without any neurological problems, however they walk with their foot plantar-flexed. These children often suffer poor sport performance leading to low exercise levels and the associated consequences. If the condition is not treated, the ITW children eventually develop abnormal gait pattern as adults and could suffer from postural problems...
2008: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
David E Westberry, Jon R Davids, Roy B Davis, Mauro César de Morais Filho
PURPOSE: The differential diagnosis in children who walk on their toes includes mild spastic diplegia and idiopathic toe walking (ITW). A diagnosis of ITW is often one of exclusion. To better characterize the diagnosis of ITW, quantitative gait analysis was utilized in a series of patients with an established diagnosis of ITW. STUDY DESIGN: Patients with an established diagnosis of ITW were analyzed by quantitative gait analysis. Data were recorded as each subject walked in a self-selected toe-walking pattern...
April 2008: Journal of Pediatric Orthopedics
Anna Fox, Sue Deakin, Gill Pettigrew, Robin Paton
Idiopathic toe-walking is defined as persistent toe-walking in a normal child in the absence of developmental, neurological or neuromuscular conditions. True idiopathic toe-walking is a rare referral, representing approximately 1:100 new patients seen in the Paediatric Orthopaedic Clinic. A prospective study of idiopathic toe-walking (ITW) was organised between 1999 and 2003. Patients underwent full history, neurological examination and assessment of ankle dorsiflexion, followed by below-knee weight-bearing casting...
December 2006: Acta Orthopaedica Belgica
Christine Alvarez, Mary De Vera, Richard Beauchamp, Valerie Ward, Alec Black
Idiopathic toe walking (ITW), considered abnormal after the age of 3 years, is a common complaint seen by medical professionals, especially orthopaedic surgeons and physiotherapists. A classification for idiopathic toe walking would be helpful to better understand the condition, delineate true idiopathic toe walkers from patients with other conditions, and allow for assignment of a severity gradation, thereby directing management of ITW. The purpose of this study was to describe idiopathic toe walking and develop a toe walking classification scheme in a large sample of children...
September 2007: Gait & Posture
Mark L McMulkin, Glen O Baird, Paul M Caskey, Ron L Ferguson
The treatment of idiopathic toe walking in children can include surgical lengthening of the gastrocnemius/soleus complex after conservative options have been ineffective. Previous outcome reports of surgery for idiopathic toe walkers have largely been limited to assessing the sagittal plane motion of dorsiflexion/plantar flexion with minimal quantitative preoperative and postoperative analysis. The purpose of this study was to comprehensively assess the outcome of idiopathic toe walkers that had been treated surgically...
September 2006: Journal of Pediatric Orthopedics
Stéphane Armand, Eric Watelain, Moïse Mercier, Ghislaine Lensel, François-Xavier Lepoutre
A database of 1,736 patients and 2,511 gait analyses was reviewed to identify for trials where the first rocker was absent. A fuzzy c-means algorithm was used to identify sagittal ankle kinematic patterns and three groups were identified. The first showed a progressive dorsiflexion during the stance phase, while the second had a short-lived dorsiflexion, followed by a progressive plantarflexion. The third group exhibited a double bump pattern, moving successively from a short-lived dorsiflexion to a short-lived plantarflexion and then returning to a further short-lived dorsiflexion before ending with plantarflexion until toe-off...
February 2006: Gait & Posture
Denis Brunt, Raymund Woo, Hyeong Dong Kim, Man Soo Ko, Claudia Senesac, Shuman Li
The purpose of this study was to determine the effects of botulinum toxin type A treatment on ankle muscle activity during gait of children who are idiopathic toe-walkers. Five children who were idiopathic toe-walkers with a mean age was 4.34 years participated. Gait of the subjects was evaluated prior to, 20 days following, and 12 months following bilateral botulinum toxin type A injection of the gastrocnemius and soleus muscles. Subjects received physical therapy following the 20-day evaluation. Dependent variables were type of foot contact pattern and duration of swing-phase tibialis anterior activity and onset of stance-phase gastrocnemius relative to ground contact...
2004: Journal of Surgical Orthopaedic Advances
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