Vibration Perception Thresholds in Children With Idiopathic Toe Walking Gait

Williams, Cylie; Tinley, Paul; Curtin, Michael; Nielsen, Sharon

doi:10.1177/0883073811432748

Cited by 34 publications

(43 citation statements)

References 19 publications

(25 reference statements)

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“…Evidence-based management for ITW remains an ongoing challenge for several reasons. First, although some children present with some similar features (Williams et al, 2014), many trials may include heterogeneous populations (Fanchiang et al, 2014;Williams, Tinley, Curtin, & Nielsen, 2012). Second, although observational studies of ITW provide evidence of spontaneous resolution in a proportion of cases (Davies et al, 2018;D.M.…”

Section: Discussionmentioning

confidence: 99%

Exploring health professionals' understanding of evidence‐based treatment for idiopathic toe walking

Williams

Gray

Davies

et al. 2020

Child

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Background Idiopathic toe walking (ITW) is an exclusionary diagnosis resulting in a child walking on the balls of their feet. Preferred treatment options may be due to the severity of the toe or the health professional preference There are limited guidelines supporting consistent treatment recommendations for this condition. This research aimed to understand agreement between health professionals' knowledge of evidence for common treatment strategies for ITW and if health professionals supported these strategies being used in clinical practice. Methods An international online survey was opened to registered health professionals who treat children with ITW between July 2017 and March 2018. The survey had two components: (a) demographic variables and variables relating to knowledge of evidence about ITW treatments and (b) support for common treatment strategies. Additional data on strategy use, referrals, and preference were collected. Kappa statistics described intra‐rater agreement between evidence knowledge and support. Multivariable regression analyses identified factors associated with the 10 most commonly preferred treatments. Results There were 908 international responses. Kappa agreement for paired correct responses determined a fair agreement for evidence support knowledge for four strategies including watch and wait (Kappa = 0.24), stretching (Kappa = 0.30), sensory integration strategies (Kappa = 0.40), and motor control strategies (Kappa = 0.24) and moderate responses for 13 others. No strategies had greater than moderate agreement between correct knowledge of evidence and strategy support. Profession, location, number of children seen in practice, and not correctly identifying the evidence factored into many of the most commonly used strategies for ITW (p < .05). Conclusions The results from this study, which confirm a variety of interventions, are utilized in the management of ITW around the world. Furthermore, there remains a disconnection between paediatric health professionals' understanding of the evidence of common treatment strategies of ITW and a consensus for the treatment of this condition.

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Section: Discussionmentioning

confidence: 99%

Exploring health professionals' understanding of evidence‐based treatment for idiopathic toe walking

Williams

Gray

Davies

et al. 2020

Child

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“…Therefore, surgical interventions may be more successful with older children that have been toe walking for a number of years and present with a fixed contracture. Recent data suggests that toe-walking may be associated with a greater vibra-tion perception of the foot (Williams et al, 2010). Thus, a non-surgical intervention in very young children that can normalize these sensory inputs while forcing the foot into a neutral position, may serve to desensitize the foot and prevent the establishment of heel cord contractures that occur in older toe-walkers (Fox et al, 2006;Sobel et al, 1997;Williams et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Recent data suggests that toe-walking may be associated with a greater vibra-tion perception of the foot (Williams et al, 2010). Thus, a non-surgical intervention in very young children that can normalize these sensory inputs while forcing the foot into a neutral position, may serve to desensitize the foot and prevent the establishment of heel cord contractures that occur in older toe-walkers (Fox et al, 2006;Sobel et al, 1997;Williams et al, 2010). We feel that conservative serial casting is a promising modality that can be used in very young children, leaving the option open for surgical interventions at later ages if the patient regresses.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive serial casting to treat idiopathic toe walking in an 18-month old child

Pistilli

Rice

Pergami

et al. 2014

NRE

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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. METHODS: A series of below knee casts was used to provide a consistent stretch to the plantar flexor muscles. Upon removal of each set of casts, passive range of motion at the ankles was measured with a goniometer. RESULTS: Four sets of casts, each lasting approximately one week, increased passive ankle dorsiflexion to 10 • of neutral and established a heel-toe walking gait. Improvements in ankle range of motion and gait were maintained upon repeated examinations at 3, 7, and 12 months post-casting. CONCLUSIONS: These results demonstrate that non-invasive procedures, such as serial casting, can be successful in very young children diagnosed as idiopathic toe walkers. Early identification and intervention for this diagnosis may eliminate the need for invasive surgeries and associated risks in this population.

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“…The subject is presented with two staircases: one starts with an intensity above the vibration perception threshold, and the other with an intensity below the threshold. The superiority of this method over the upward staircase method, as used by Williams et al [17] to measure perception thresholds, has been discussed by Cornsweet [18]. With the upward staircase method, subjects tend to be biased in their subsequent responses after several identical responses.…”

Section: Experiments Designmentioning

confidence: 99%

HAPTIC: Haptic Anatomical Positioning to Improve Clinical Monitoring

Gay-Betton¹,

Alirezaee²,

Cooperstock³

et al. 2017

Proceedings of the Conference on Design and Semantics of Form and Movement - Sense and Sensitivity, DeSForM 2017

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Hospitals are inundated by the sounds of patient monitoring devices and alarms. These are meant to help, yet also create a stressful environment for physicians and patients. To address this issue, we consider the possibility of delivering complementary haptic alarm stimuli via a wearable tactile display. This may reduce the necessity for the plethora of audible alarms in the Intensive Care Unit and Operating Room, potentially decreasing fatigue among clinicians, and improving sleep quality for patients. The study described here sought to determine a suitable anatomical location where such a tactile display could be worn. Although the wrist is an obvious default, based on the success of smartwatches and fitness monitors, wearable devices below the elbow are disallowed in aseptic procedural environments. We hypothesized that haptic perception would be approximately equivalent at the wrist and ankle, and confirmed this experimentally. Thus, for a healthcare setting, we suggest that the ankle is a suitable alternative for the placement of a tactile display.

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Vibration Perception Thresholds in Children With Idiopathic Toe Walking Gait

Cited by 34 publications

References 19 publications

Exploring health professionals' understanding of evidence‐based treatment for idiopathic toe walking

Exploring health professionals' understanding of evidence‐based treatment for idiopathic toe walking

Non-invasive serial casting to treat idiopathic toe walking in an 18-month old child

HAPTIC: Haptic Anatomical Positioning to Improve Clinical Monitoring

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