Idiopathic Toe Walking

Pomarino, David; Llamas, Juliana Ramírez; Pomarino, Andrea

doi:10.1177/1938640016630056

Cited by 19 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the study by Bernhard et al, 17 the main objectives of physical therapy for children with ITW, are to obtain stability of the trunk muscles, and to 17 Pomarino et al (2011) 18 Pomarino et al (2011) 19 Pomarino et al (2011) 20 Van Kujik et al (2014) 21 Fox et al (2006) 22 Pomarino et al (2011) 23 Pomarino and Pomarino (2010) 24 Pomarino et al (2010) 15 Gámez-Iruela et al (2015) 25 Hemo et al (2006) 11 Pomarino et al (2011) 26 Pomarino et al (2009) 27 Pomarino et al (2012) 16 Williams et al (2014) 28 Jahn et al (2009) 29 Pomarino et al (2010) 30 Pomarino et al (2009) 31 Babb and Carlson (2008) 32 Williams et al (2014) 33 Pomarino et al (2010) 34 Külh and Pomarino (2008) 35 Brunt et al (2004) 36 Pomarino et al (2010) 15 Pomarino, et al (2007) 37 Zimbler (2007) 38 Pomarino and Bernhard (2006) 39 Pomarino (2004) 40 Engström et al (2010) 10 Bernhard et al (2006) 41 Clark et al (2010) 13 Hirsch and Wagner (2004) 42 Lundequam and Buck Willis (2009) 43 Williams et al (2013) 9 McEwen-Hill and Weber (2009) 44 Stott et al (2004) 14 Stock and Zörnig (2010) 45 Engström et al (2013) 8 elongate the Achilles tendon; the exercises or therapy have to be done regularly. Splints are an alternative treatment option, which aim to reposition the ankle in neutral position for at least 6 weeks.…”

Section: Resultsmentioning

confidence: 99%

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

Pomarino

Ramírez-Llamas

Martin

et al. 2016

Foot & Ankle Specialist

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

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

Pomarino

Ramírez-Llamas

Martin

et al. 2016

Foot & Ankle Specialist

Self Cite

View full text Add to dashboard Cite

show abstract

“…Five clinical tests were used to assess ITW severity in 836 children, aged between 2 and 17 years. 17 44 For all tests, participants with positive family predisposition ( n = 352) were found to be “more severely affected by toe-walking” than those with negative family predisposition ( n = 484). 17 In examining gender distribution, males presented with ITW at a significantly greater frequency than females.…”

Section: Discussionmentioning

confidence: 98%

“…The diagnosis of idiopathic toe-walking (ITW) is reserved for children who walk on their toes, 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 make initial contact (IC) with toes/forefoot, 24 25 26 have toe–toe gait pattern, 27 28 29 30 31 or have the absence of heel strike. 1 14 20 23 31 32 33 34 35 36 37 38 39 40 41 42 43 It is one of exclusion, in which no known neurological, neuromuscular, orthopedic, or neurodevelopmental cause, e.g., cerebral palsy (CP), muscular dystrophy, or autism, can be found for the patient's condition.…”

Section: Introductionmentioning

confidence: 99%

“…Characteristics that have been associated with ITW include the achievement of independent ambulation within normal age range, 10 13 20 24 28 40 toe-walking starting at the onset of independent ambulation, 9 10 11 17 28 44 bilateral involvement, 3 20 ability to stand in plantigrade, 13 17 44 45 ability to not walk on toes upon request, 9 11 13 14 17 22 26 29 35 38 44 46 47 normal developmental gait variant, 4 8 12 19 22 37 47 48 49 50 toe walk for more than 3 months 6 51 or 6 months, 17 19 44 and transient normal stage that becomes pathological if persists beyond 2 10 13 25 28 30 37 45 52 53 or 3 years of age. 1 7 14 18 19 20 23 25 27 32 33 35 36 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Idiopathic Toe-Walking: A Review from 1967 to 2021

Sala¹

2022

Journal of Pediatric Neurology

View full text Add to dashboard Cite

Idiopathic 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.

show abstract

“…Children who idiopathically toe-walk (ITW) present with an atypical gait pattern, despite no detected orthopaedic or neurological cause (Pomarino et al, 2016). Whilst the main pathology presents at the ankle joint, more proximal joints must also be considered, as weakness of the hip and knee joint muscles have previously been suggested…”

Section: Introductionmentioning

confidence: 99%

In vivo operating lengths of the gastrocnemius muscle during gait in children who idiopathically toe‐walk

Harkness-Armstrong

Maganaris

Walton

et al. 2021

Experimental Physiology

View full text Add to dashboard Cite

Children who idiopathically toe-walk (ITW) habitually operate at greater plantarflexion angles than typically developing (TD) children, which might result in shorter, sub-optimal gastrocnemius fascicle lengths. However, currently no experimental evidence exists to substantiate this notion. Five children who ITW and 14 TD children completed a gait analysis, whilst gastrocnemius fascicle behaviour was simultaneously quantified using ultrasound. The moment-angle (hip, knee and ankle) and moment-length (gastrocnemius) relationships were determined from isometric maximum voluntary contractions (MVC) on an isokinetic dynamometer combined with ultrasound. During gait, children who ITW operated at more plantarflexed angles (Δ = 20 • ; P = 0.013) and longer muscle fascicle lengths (Δ = 12 mm; P = 0.008) than TD children. During MVC, no differences in the peak moment of any joint were found. However, peak plantarflexor moment occurred at significantly more plantarflexed angles (−16 vs. 1 • ; P = 0.010) and at longer muscle fascicle lengths (44 vs. 37 mm; P = 0.001) in children who ITW than TD children. Observed alterations in the moment-angle and moment-length relationships of children who ITW coincided with the ranges used during gait. Therefore, the gastrocnemius muscle in children who ITW operates close to the peak of the force-length relationship, similarly to TD children. Thus, this study indicates that idiopathic toe-walking is truly an ankle joint pathology, and children who ITW present with substantial alterations in the gastrocnemius muscle functional properties, which appear well adapted to the characteristic demands of equinus gait. These findings should be considered when prescribing clinical treatments to restore typical gait. K E Y W O R D S equinus, idiopathic toe-walking, muscle, ultrasoundThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

show abstract

Idiopathic Toe Walking

Abstract: Diagnostic, Level II: development of diagnostic test with consecutive patients and control patients.

Cited by 19 publications

References 14 publications

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

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

Idiopathic Toe-Walking: A Review from 1967 to 2021

In vivo operating lengths of the gastrocnemius muscle during gait in children who idiopathically toe‐walk

Contact Info

Product

Resources

About