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Idiopathic toe walker

David Pomarino, Stephan Martin, Andrea Pomarino, Stefanie Morigeau, Saskia Biskup
Idiopathic toe walking (ITW) is a pathological gait pattern in which children walk on their tip toes with no orthopedic or neurological reason. Physiological characteristics of the gastrocnemius muscles, the Achilles tendon, and the foot of toe walkers differ from subjects with a plantigrade walking pattern. McArdle's disease is characterized by the inability to break down muscle glycogen. It is an autosomal-recessive condition, characterized by low exercise tolerance, muscular atrophy at the shoulder girdle, episodes of myoglobinuria after vigorous physical activities and the occurrence of the second wind phenomenon...
June 2018: Journal of Orthopaedics
Pähr Engström, Kristina Tedroff
BACKGROUND: Children with idiopathic toe-walking, a common pediatric condition, walk some or all of the time on their toes. This condition often causes parental concern, with repeated medical contacts and a range of interventions including stretching, casts, injection of botulinum toxin A, and surgical procedures. The purpose of this cohort study was to document the natural history of this condition. METHODS: In a population-based cohort of 1,401 healthy 5.5-year-old Swedish children, we found the prevalence of idiopathic toe-walking to be approximately 5% (63 of 1,401)...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
Kerstin Radtke, Nataliia Karch, Fabian Goede, Bernhard Vaske, Gabriela von Lewinski, Yvonne Noll, Anneke Thren
Idiopathic toe walking (ITW) causes a common problem in pediatric orthopaedics. In the literature, numerous treatment options have been reported, but consensus about the management of ITW is still missing. The aim of the current study was to evaluate conservative treatment with pyramidal insoles. A total of 193 patients underwent conservative treatment between January 2010 and June 2013. Mean age at the beginning of the treatment was 7.75 ± 0.23 years (range 2.0-17.0 years). For all patients, demographic data, comorbid diseases, passive range of motion (ROM), persistent toe walking, and performed operations were retrospectively evaluated...
March 1, 2018: Foot & Ankle Specialist
Essi Marttinen Rossi, Päivi Nevalainen, Helena Mäenpää, Leena Lauronen
Idiopathic toe walking is a relatively common developmental condition often leading to secondary problems such as pain and muscle contractures in the lower extremities. The cause of idiopathic toe walking is unknown, which hinders the development of treatment strategies. To test whether children with idiopathic toe walking have functional alterations in their spinal motor circuits, we studied the properties of the soleus H-reflex and its modulation with vibration in 26 idiopathic toe walkers and 16 typically developing children...
April 2018: Journal of Child Neurology
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
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