Treatment for Idiopathic Toe-Walking

Treatment for idiopathic toe walking: A systematic review of the literature

“…The effectiveness of PT (motor control intervention) was examined in one study (17), serial casting in 3 (15,23,31), BTX-A in 4 (24,26,27,33), and surgery in 5 studies (14,28,30,34,35). Six studies (1 RCT and 5 non-randomized, uncontrolled studies) compared the effects of different interventions (16,18,22,25,29,32). criteria for the use of a particular type of intervention, however, were not provided.…”

“…however, the operationalization of the concept "diagnosis of exclusion" differed substantially between the studies. In 1 study the concept was not specified at all (28), in the other 18 studies at least neurological deficits were ruled out, either by history-taking (15,17,24,25), 5 studies excluded psychological or behavioural problems (15,18,23,25,32), and 8 studies excluded orthopaedic problems other than equinus deformity of the ankle (14,15,18,22,23,29,31,34). The inclusion criteria in 10 studies were dominated by their retro spective nature.…”

“…Two studies incorporated a non-treatment group (16,32), whereas 2 other studies used a group of children with cerebral palsy for comparison (31,35). one study incorporated data from an age-matched control group on repetitive single-heel rises on the force plate (29), whereas 7 studies incorporated historical data from a laboratory database of healthy controls (23,29,30,33). In only one of these studies, the historical data were used for quantitative comparisons (30).…”

“…criteria for the use of a particular type of intervention, however, were not provided. In general, only patients not responding to conservative treatment and with (severe) fixed contractures were included in surgical studies (16,29,30,34). With regard to the same type of intervention, there was no standardized treatment protocol within or between studies, either with respect to treatment algorithm, the use of co-interventions or duration of treatment, or with respect to post-intervention management (Table I).…”

Baby walkers and the phenomenon of toe-walking

“…Функционально нарушения могут про-являться незначительной ретракцией (контрак-турой) икроножно-камбаловидного комплекса [29,[34][35][36]. Это в свете предложенной гипотезы может происходить из-за гипертренированности разгибателей стопы у «ходунковых» детей.…”