Little Evidence for Conservative Toe Walking Interventions in Autism Spectrum Disorders: a Systematic Review

Abstract

This systematic review summarizes the evidence about toe walking (TW) interventions in persons with autism. Following the PRISMA guidelines, a systematic search of MEDLINE, CINAHL, PsycINFO, The Cochrane Library, Google Scholar, and Opengrey was performed. Nine articles (all case reports or case series) were included. Methodological quality was assessed using the Mayo Evidence-Based Practice Centre tool. The included studies considered 17 subjects (16 males; age range: 4–15 years). All studies reported a reduction of TW frequency, but the follow-up was lacking in seven studies. There is a lack of high-quality studies with a sufficiently large and well-characterized sample to assess the effectiveness of TW interventions in autistic persons. These findings strongly support the need for further research in this area.

Sensory Profile of Children and Adolescents with Autism Spectrum Disorder and Tip-Toe Behavior: Results of an Observational Pilot Study

“…With regard to therapeutic possibilities and indications, a recent systematic review summarized the evidence on conservative, pharmacological, and surgical interventions for TW in individuals with ASD [ 61 ]. The authors included nine papers, all with a case study—case report study design.…”

“…Serial casting +/− orthoses and behavioral interventions (i.e., using acoustic feedback associated with positive reinforcement, or a wristband as a discriminative stimulus) were the most studied interventions. Moreover, despite pharmacological and surgical interventions being used to treat TTB in persons with autism in clinical practice [ 62 ], no studies that assess effectiveness of pharmacological and surgical interventions were found [ 61 ].…”