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Chu V, Girolami GL, Grant-Beuttler M. Assessing sensory processing differences in children with idiopathic toe walking: A pilot study. Physiother Theory Pract 2023; 39:2314-2326. [PMID: 35581534 DOI: 10.1080/09593985.2022.2073929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
Idiopathic toe-walking (ITW) refers to persistent walking without heel contact for unknown reasons. An underexplored area is the relationship of sensory processing to ITW. This study presents methods to assess sensory differences in individuals with ITW and summarizes results from a pilot testing of the measures. This pilot study included nine children and one young adult with ITW. Ten age-matched controls were recruited to provide a comparison group when norms were not available in the literature. The measures included in this study were as follows: sensory questionnaires; electrodermal activity response to sensory stimuli; monofilaments; biothesiometer; gait on different surfaces; NeuroCom® SMART Balance Master® Sensory Organization Test and Adaptation Test; and ankle position matching. All study procedures were completed in about 3 hours. Children as young as 4 years were able to complete the measures. We observed overall differences in sensory processing, specifically, higher Sensory Processing Measure scores (p = .011), higher resting electrodermal activity (p = .012), increases in heel-toe walking on novel surfaces (p = .034), and more falls with balance perturbation (p = .007) in individuals with ITW. A subset of individuals also showed tactile hyposensitivity (5 out of 10 in the ITW group) and poor equilibrium scores in the Sensory Organization Test (4 out of 9 in the ITW group, 1 unable to complete the test). Our results confirmed the heterogeneity in the etiology of ITW. We propose that further testing in sensory modulation, tactile processing, and vestibular processing is needed to fully explore the impact of sensory processing on children with ITW.
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Affiliation(s)
- Virginia Chu
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Gay L Girolami
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
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Pomarino D, Emelina A, Heidrich J, Rostásy K, Schirmer S, Schönfeldt JO, Thren A, Wagner F, Thren JR, Berger N. NGS-Panel Diagnosis Developed for the Differential Diagnosis of Idiopathic Toe Walking and Its Application for the Investigation of Possible Genetic Causes for the Gait Anomaly. Glob Med Genet 2023; 10:63-71. [PMID: 37091313 PMCID: PMC10121371 DOI: 10.1055/s-0043-57230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
Idiopathic toe walking (ITW) describes a condition affecting approximately 4.5% of children. Toe walking is an accompanying symptom for many hereditary disorders. This retrospective study uses next-generation sequencing-panel-diagnosis to investigate the feasibility of genetic testing to research the possible genetic causes of ITW and for differential diagnosis. Data were taken from our inhouse database, the minimum age for participants was 3 years. Underlying neurological or orthopaedic conditions were tested for and ruled out prior to diagnosing ITW. Patients, who experienced complications before, during or immediately after birth, children with autism, and patients toe walking less than 50% of the time were excluded. Eighty-nine patients were included in the study, in which 66 (74.2%) patients were boys and 23 (25.8%) girls. Mean age at testing was 7.7 years (range: 3-17 years). Fifteen of the 89 patients included in the study (16.9%) had a genetic variant identified as likely pathogenic or pathogenic by the genetics laboratory. Additionally, we found 129 variants of uncertain significance. About 65.2% of patients showed a pes cavus foot deformity, 27% of patients reportedly had at least one relative who also displayed the gait anomaly, and 37.1% had problems with their speech development. Despite the limitations of the sample size and the scope of our genetic testing targets, our results indicate that research into the genetic causes of ITW could better our understanding of the causes of ITW in otherwise healthy children, to help develop novel methods to detect serious conditions early. ITW could be an early onset symptom for further hereditary conditions.
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Affiliation(s)
| | | | - Jens Heidrich
- Labor Dr. Heidrich und Kollegen MVZ GmbH, Hamburg, Germany
| | | | | | | | - Anneke Thren
- Kinderorthopädie am Pferdeturm, Hanover, Germany
| | - Ferdinand Wagner
- Department of Orthopedics and Trauma Surgery, Musculoskeletal University Center Munich, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Johanna Ronja Thren
- Anthropology Department, Durham University, Durham, United Kingdom
- Address for correspondence Johanna Ronja Thren, BA, MSc Department of Anthropology, Durham UniversityDurham DH15BXUnited Kingdom
| | - Nina Berger
- Institut für Kinderneurologie, Hamburg, Germany
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Donne J, Farrell MJ, Kolic J, Powell J, Fahey M, Williams C. Two-point discrimination responses in children with idiopathic toe walking: A feasibility fMRI study. Sci Prog 2022; 105:368504221132141. [PMID: 36373762 PMCID: PMC10306138 DOI: 10.1177/00368504221132141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Idiopathic toe walking (ITW) is a diagnosis given to children who walk with an absence or limitation of heel strike in the contact phase of the gait cycle, that are otherwise typically developing. There is emerging evidence that this gait pattern may occur in children who experience tactile sensory processing challenges. This feasibility study aimed to determine if children were able to respond to a sensory stimulus during a fMRI. Children aged between 8-16 years of age, with and without idiopathic toe walking were recruited from general public advertising. Participants were required to perform a two-point discrimination test (task block) and press a button without being tested (control block) during an fMRI using a standard block design. Activation differences were examined in the left frontal pole, left supramarginal gyrus, left parahippocampal gyrus, left paracingulate gyrus and the right superior temporal. Five children were in the typically developing (TD) group and three were in the ITW group. There were between-group activation differences in the decision-making block compared to the control block in the left frontal lobe, parahippocampal gyrus and the right superior temporal gyrus. There was greater variation in activation in the left supramarginal gyrus and the left paracingulate gyrus in the ITW group compared to the typically developing group. Based on this study a future sample size of 15 children per group will be required to detect an adequate effect across chosen regions of interest Conducting fMRI using two-point discrimination testing on this population is feasible. Further research is required with larger population sizes to determine if brain activation patterns during the sensory input decision-making process are different in this population.
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Affiliation(s)
- Jack Donne
- School of Primary and Allied Health, Monash University, Frankston, VIC, Australia
| | - Michael J Farrell
- Department of Medical Imaging and
Radiation Sciences, Monash Biomedical Imaging, Clayton, VIC, Australia
| | - Jessica Kolic
- Allied Health, Peninsula Health, Frankston, VIC, Australia
| | - Jennifer Powell
- School of Medicine, The University of
Queensland, Queensland Children's Hospital, Saint Lucia, Australia
| | - Michael Fahey
- Department of Neurology, Monash
Children's Hospital, Clayton, VIC, Australia
| | - Cylie Williams
- School of Primary and Allied Health, Monash University, Frankston, VIC, Australia
- Allied Health, Peninsula Health, Frankston, VIC, Australia
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Valagussa G, Purpura G, Nale A, Pirovano R, Mazzucchelli M, Grossi E, Perin C. Sensory Profile of Children and Adolescents with Autism Spectrum Disorder and Tip-Toe Behavior: Results of an Observational Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091336. [PMID: 36138645 PMCID: PMC9497722 DOI: 10.3390/children9091336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 02/05/2023]
Abstract
Atypical sensory processing is frequently reported in persons with autism spectrum disorders (ASD), and it is one of the described diagnostic criteria for ASD. There is also mounting literature supporting the presence of motor impairments in individuals with ASD. Among these motor signs, tip-toe behavior (TTB) is a possible clinical finding, but its etiology is not clearly understood. It is suggested that TTB in ASD could be a sign of a sensory modulation impairment, but evidence is lacking and controversial. The main aim of this pilot study is to explore sensory features in a sample (4 females; 28 males) of children and adolescents with ASD (age range: 7-18). All participants also presented Intellectual Disability. Participants were divided in two groups, matched for age and gender, on the basis of the presence or absence of TTB (16 ASD TTB group vs. 16 ASD NO-TTB group) and then evaluated by using the Short Sensory Profile. We found that both ASD groups tend to significantly present sensory-related behavioral symptoms, but ASD TTB individuals more frequently showed the specific pattern of "under responsive/seeks sensation" than ASD NO-TTB individuals. These preliminary findings support that sensory-motor features might be taken into consideration when rehabilitation for TTB in children and adolescents with ASD is necessary.
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Affiliation(s)
- Giulio Valagussa
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio, 22100 Como, Italy
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Giulia Purpura
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Alessandra Nale
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio, 22100 Como, Italy
| | - Rita Pirovano
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio, 22100 Como, Italy
| | - Miryam Mazzucchelli
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa S. Maria Foundation, Tavernerio, 22100 Como, Italy
| | - Cecilia Perin
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
- Correspondence:
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Sala DA. Idiopathic Toe-Walking: A Review from 1967 to 2021. JOURNAL OF PEDIATRIC NEUROLOGY 2022. [DOI: 10.1055/s-0042-1742583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractIdiopathic toe-walking (ITW) is considered a diagnosis of exclusion for which no underlying neurological, neuromuscular, neurodevelopmental, or orthopedic condition can be identified. The purpose of this review was to examine multiple aspects of ITW: natural history, evaluation, treatment, musculoskeletal manifestations, and developmental issues through the review of studies from the initial description of condition in 1967 to the present. From a PubMed search and review of reference lists of individual articles, 64 articles were selected and reviewed. The studied samples were variably described and often not well-defined. Gait analysis found gait characteristics associated with ITW that varied from normal. Children with ITW can be differentiated from children with cerebral palsy on the basis of several gait pattern features, but findings from electromyographic comparisons were variable. Treatments included orthoses, casting, botulinum toxin type A, and surgery. The evidence to support any specific treatment is limited by the small sample size and short duration of follow-up in the majority of studies. The inadequacy of the current literature suggests the need for a longitudinal multi-center study to more clearly define the population of children with ITW and to determine indications, timing, and effectiveness of the various available treatments.
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Affiliation(s)
- Debra A. Sala
- Pediatric Physical Therapist, Private Practice, New York, New York
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6
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Wilder DA, Ingram G, Hodges AC. Evaluation of shoe inserts to reduce toe walking in young children with autism. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- David A. Wilder
- The Scott Center for Autism Treatment Florida Institute of Technology Melbourne Florida USA
| | - Grant Ingram
- The Scott Center for Autism Treatment Florida Institute of Technology Melbourne Florida USA
| | - Ansley C. Hodges
- Department of Applied Behavior Analysis Nemours Children's Hospital Orlando Florida USA
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7
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Berger N, Bauer M, Hapfelmeier A, Salzmann M, Prodinger PM. Orthotic treatment of idiopathic toe walking with a lower leg orthosis with circular subtalar blocking. BMC Musculoskelet Disord 2021; 22:520. [PMID: 34098918 PMCID: PMC8183056 DOI: 10.1186/s12891-021-04327-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is no universally accepted treatment standard for idiopathic toe walking patients (ITW) in the current literature. None of the established methods provide homogenous satisfying results. In our department we treat ITW patients with lower leg orthoses with a circular foot unit for a total of 16 weeks. In this study we reviewed our database to evaluate the success of our treatment protocol for a 24 months follow up period. RESULTS Twenty-two patients were included in this study. Age at the beginning of treatment was 7.0 years +/- 2.9 (range 2.5-13.1). Percentage of ITW at the beginning of treatment according to the perception of the parents was 89% +/- 22.2 (range 50-100). Immediately after the treatment with our device, percentage of ITW dropped to 11% +/- 13.2 (range 0-50). After 12 months, 73% of the patients (16/22) walked completely normal or showed ITW less than 10% of the day. After 24 months, 64% of the patients kept a normal gait (14/22). CONCLUSION This study provides evidence that the treatment of idiopathic toe walking with lower leg orthoses with a circular foot unit results in satisfying long-term results in two thirds of the patients.
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Affiliation(s)
- N Berger
- Children's Orthopaedics, University Hospital Rechts der Isar, Munich, Germany.
| | - M Bauer
- Cand. med, Technical University Munich, Munich, Germany
| | - A Hapfelmeier
- Institute of General Practice and Health Services Research, Technical University of Munich. Institute of Medical Informatics, Statistics and Epidemiology, Technical University of Munich, Munich, Germany
| | - M Salzmann
- Children's Orthopaedics, University Hospital Rechts der Isar, Munich, Germany
| | - P M Prodinger
- Orthopaedics, Krankenhaus Agatharied, Agatharied, Germany
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Caserta AJ, Pacey V, Fahey MC, Gray K, Engelbert RHH, Williams CM. Interventions for idiopathic toe walking. Cochrane Database Syst Rev 2019; 10:CD012363. [PMID: 31587271 PMCID: PMC6778693 DOI: 10.1002/14651858.cd012363.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Idiopathic toe walking (ITW) is an exclusionary diagnosis given to healthy children who persist in walking on their toes after they should typically have achieved a heel-toe gait. The literature discusses conservative and surgical interventions using a variety of treatment modalities. Young children and children without a limitation in ankle dorsiflexion (the upwards movement of the foot towards the shin of the leg) are commonly treated with conservative interventions. Older children who continue toe walking and present with limitations in ankle dorsiflexion are sometimes treated with surgical procedures. This systematic review is needed to evaluate the evidence for any intervention for the treatment of ITW. The conclusions of this review may support decision making by clinicians caring for children with ITW. It may also assist families when deciding on treatment options for their children with ITW. Many of the treatments employed have financial implications for parents or healthcare services. This review also aims to highlight any deficits in the current research base. OBJECTIVES To assess the effects of conservative and surgical interventions in children with ITW, specifically effects on gait normalisation, ankle range of motion, pain, frequency of recurrence, and any adverse effects. SEARCH METHODS On 29 April 2019, we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL Plus, and PEDro. We searched the following registers of clinical trials for ongoing and recently completed trials: the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP, apps.who.int/trialsearch), and ClinicalTrials.gov (clinicaltrials.gov). We searched conference proceedings and other grey literature in the BIOSIS databases and System for Information on Grey Literature in Europe (OpenGrey, opengrey.eu). We searched guidelines via the Turning Research Into Practice database (TRIP, tripdatabase.com) and National Guideline Clearinghouse (guideline.gov). We did not apply language restrictions. SELECTION CRITERIA We considered randomised or quasi-randomised trials for inclusion in the review if they involved participants diagnosed with ITW gait in the absence of a medical condition known to cause toe walking, or associated with toe walking. As there is no universally accepted age group for ITW, this review includes ITW at any age, who have been toe walking for more than six months, who can or cannot walk with a heel-toe gait, and who may or may not have limited dorsiflexion of the ankle joint. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures. The primary outcome was improvement in toe walking (defined as greater than 50% of time spent heel-toe walking). Secondary outcomes were active and passive range of motion of the ankle joint, pain, recurrence of ITW after treatment, and adverse events. We assessed the certainty of the evidence using the GRADE framework. MAIN RESULTS Four studies, comprising 104 participants, met the inclusion criteria. One study did not report data within the appropriate follow-up timeframe and data from two studies were insufficient for analysis. The single study from which we extracted data had 47 participants and was a randomised, controlled, parallel-group trial conducted in Sweden. It tested the hypothesis that combined treatment with serial casting and botulinum toxin type A (BTX) was more effective than serial casting alone in reducing ITW gait.This study found that more participants treated with BTX improved (defined as toe walking less than 50% of the time, as reported by parents) (risk ratio (RR) 1.21, 95% confidence interval (CI) 0.57 to 2.55; 1 trial, 46 participants; very low-certainty evidence). However, there was little or no difference between groups in passive ankle joint dorsiflexion range of movement on the right with the knee extended (mean difference (MD) -1.48º, 95% CI -4.13 to 1.16; 1 trial, 47 participants), on the right with the knee flexed (MD -0.04º, 95% CI -1.80 to 1.73; 1 trial, 46 participants), on the left with the knee flexed (MD 1.07, 95% CI -1.22 to 3.37), or on the left with the knee extended (MD 0.05, 95% CI -0.91 to 1.91). Nor was there a clear difference between the groups in recurrence of toe-walking gait (assessed via severity of toe walking (graded 1 (mild), 2 (moderate), or 3 (severe)) on gait analysis, analysed as continuous data: MD 0.34 points, 95% CI -0.09 to 0.78; 46 participants). In principle, MDs greater than zero (i.e.) positive values) would favour BTX and casting and negative values would favour casting alone. We have not reported effects as better or worse because all results were from evidence of very low certainty. We downgraded the certainty of evidence because of study limitations (outcome assessment was not blinded) and imprecision. Outcomes of pain and active range of motion were not reported in the included study.In terms of adverse events, calf pain was reported twice in the casting-only group and three times in the BTX group. There were three minor skin problems in each group and one reported case of pain directly after BTX injection. The report did not state if calf pain and skin irritation were from the same or different participants. The study authors reported that adverse events did not alter treatment adherence. AUTHORS' CONCLUSIONS The certainty of evidence from one study, which compared serial casting with serial casting with BTX for ITW in children, was too low for conclusions to be drawn. A further three studies reported outcomes relating to BTX, footwear, exercises, and different types of orthoses as interventions, however the outcome data were too limited to assess their effects.
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Affiliation(s)
- Antoni J Caserta
- Monash HealthChild and Family Team140‐154 Sladen StCranbourneVictoriaAustralia3977
| | - Verity Pacey
- Macquarie UniversityDepartment of Health Professions, Faculty of Medicine and Health Sciences75 Talavera RoadSydneyNSWAustralia2109
| | - Michael C Fahey
- Monash UniversityDepartment of PaediatricsClaytonVictoriaAustralia3168
| | - Kelly Gray
- The Children's Hospital at WestmeadDepartment of EndocrinologyLocked Bag 4001WestmeadNew South WalesAustralia2145
- Macquarie UniversityDepartment of Health Professions, Faculty of Medicine and Health SciencesGround Floor75 Talavera RoadNorth RydeNSWAustralia2109
| | - Raoul HH Engelbert
- Department of Rehabilitation MedicineAcademic Medical Center AmsterdamAmsterdamAmsterdamNetherlands
| | - Cylie M Williams
- Monash UniversityDepartment of PhysiotherapyFrankstonVictoriaAustralia
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Thielemann F, Rockstroh G, Mehrholz J, Druschel C. Serial ankle casts for patients with idiopathic toe walking: effects on functional gait parameters. J Child Orthop 2019; 13:147-154. [PMID: 30996738 PMCID: PMC6442509 DOI: 10.1302/1863-2548.13.180183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The aim of the present study was to investigate the functional effects on gait parameters of serial ankle casts for patients with idiopathic toe walking (ITW), in comparison with an unremarkable control group. METHODS A prospective trial with a pre-test-post-test control group design included ten patients with ITW and ten healthy matched children. Children with ITW underwent serial casting to stretch the plantar flexors, with two 14-day periods with walking plaster casts set at the maximum available ankle dorsiflexion. Both groups were assessed clinically and using a functional gait analysis before and after serial casting, as well as at a six-month follow-up visit. RESULTS The normalized plantar heel force increased from 5% pre-interventionally to 79% at the follow-up. The upper ankle-joint angle and the base angle also demonstrated significant changes. Normalized compound action potentials of the medial heads of the gastrocnemius were reduced by 70%. None of these parameters demonstrated any significant differences at the follow-up examination in comparison with the healthy control group. Variations in the displacement of the knee joint on the sagittal plane and of the center of gravity in the transverse plane did not show any significant differences in comparison with the control group. CONCLUSION The reduction of muscle tone and lengthening of the ankle plantar flexors led to persistent increased active ankle dorsiflexion with significant long-term improvement of functional kinematic parameters. No significant difference in the gait analysis was found between the ITW group and healthy children six months after treatment.Level of Evidence: Level II - Therapeutic.
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Affiliation(s)
- F. Thielemann
- University Center for Orthopaedics and Trauma Surgery, Carl Gustav Carus University Hospital, Technical University of Dresden, Dresden, Germany, Correspondence should be sent to Falk Thielemann, MD, Senior Consultant, University Center for Orthopaedics and Trauma Surgery, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany. E-mail:
| | - G. Rockstroh
- Department of Orthopaedics and Biomechanics, Klinik Bavaria Kreischa, Kreischa, Germany
| | - J. Mehrholz
- Wissenschaftliches Institut, Private Europäische Medizinische Akademie der Klinik Bavaria in Kreischa GmbH, Kreischa, Germany
| | - C. Druschel
- University Center for Orthopaedics and Trauma Surgery, Carl Gustav Carus University Hospital, Technical University of Dresden, Dresden, Germany
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Caserta A, Morgan P, Williams C. Identifying methods for quantifying lower limb changes in children with idiopathic toe walking: A systematic review. Gait Posture 2019; 67:181-186. [PMID: 30347291 DOI: 10.1016/j.gaitpost.2018.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/03/2018] [Accepted: 10/08/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Idiopathic toe walking (ITW) is a diagnosis of exclusion for children walking on their toes with no medical cause. This systematic review aimed to identify and evaluate the clinical utility, validity and reliability of the outcome measures and tools used to quantify lower limb changes within studies that included children with ITW. METHODS The following databases were searched from inception until March 2018: Ovid MEDLINE, EBESCO, Embase, CINAHL Plus, PubMed. Inclusion criteria were studies including children with ITW diagnosis, reporting use of measurement tools or methods describing lower limb characteristics, published in peer-reviewed journals, and in English. The relevant psychometric properties of measurement tools were extracted, and assessed for reported reliability and validity. Included articles were assessed for risk of bias using McMaster quality assessment tool. Results were descriptively synthesized and logistic regression used to determine associations between common assessments. RESULTS From 3164 retrieved studies, 37 full texts were screened and 27 full texts included. There were 27 different measurement tools described across joint range of motion measurement, gait analysis, electromyography, accelerometer, strength, neurological or radiology assessment. Interventional studies were more likely to report range of motion and gait analysis outcomes, than observational studies. Alvarez classification tool in conjunction with Vicon motion system appeared the contemporary choice for describing ITW gait. There was no significant association between the use of range of motion and gait analysis outcomes and any other outcome tool or assessment in all studies (p > 0.05).There was limited reliability and validity reporting for many outcome measures. SIGNIFICANCE This review highlighted that a consensus statement should be considered to guide clinicians and researchers in the choice of the most important outcome measures for this population. Having a standard set of measures will enable future treatment trials to collect similar measures thus allowing future systematic reviews to compare results.
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Affiliation(s)
- Antoni Caserta
- Monash Health Community, Cranbourne, Victoria, Australia; Monash University, Department of Physiotherapy, Frankston, Victoria, Australia.
| | - Prue Morgan
- Monash University, Department of Physiotherapy, Frankston, Victoria, Australia
| | - Cylie Williams
- Monash University, Department of Physiotherapy, Frankston, Victoria, Australia; Peninsula Health, Allied Health, Frankston Victoria, Australia
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11
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Hodges AC, Wilder DA, Ertel H. The use of a multiple schedule to decrease toe walking in a child with autism. BEHAVIORAL INTERVENTIONS 2018. [DOI: 10.1002/bin.1528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ansley C. Hodges
- Nemours Children's Hospital; Orlando FL USA
- School of Behavior Analysis; Florida Institute of Technology; Melbourne FL USA
| | - David A. Wilder
- School of Behavior Analysis; Florida Institute of Technology; Melbourne FL USA
| | - Hallie Ertel
- School of Behavior Analysis; Florida Institute of Technology; Melbourne FL USA
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12
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Williams CM, Pacey V, de Bakker PB, Caserta AJ, Gray K, Engelbert RHH. Interventions for idiopathic toe walking. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012363] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Cylie M Williams
- Monash University; Department of Physiotherapy; Frankston Victoria Australia
| | - Verity Pacey
- The Children's Hospital at Westmead; Department of Endocrinology; Cnr Hawkesbury Rd and Hainsworth St Westmead NSW Australia 2145
- Faculty of Medicine and Health Sciences, Macquarie University; Department of Health Professions; Sydney New South Wales Australia
| | - Pauline B de Bakker
- Amsterdam School of Health Professions, University of Applied Sciences Amsterdam; Education for Physiotherapy; Tafelbergweg 51, Roomnr. C1.43 Amsterdam Amsterdam Netherlands 1105 BD
| | - Antoni J Caserta
- Monash Health; Child and Family Team; 140-154 Sladen St Cranbourne Victoria Australia 3977
| | - Kelly Gray
- The Children's Hospital at Westmead; Department of Endocrinology; Cnr Hawkesbury Rd and Hainsworth St Westmead NSW Australia 2145
| | - Raoul HH Engelbert
- Department of Rehabilitation Medicine; Academic Medical Center Amsterdam; Amsterdam Amsterdam Netherlands
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