Prevalence of idiopathic toe-walking in children from birth to 10 years of age

Investigators found 79% of children who had ever been toe-walkers spontaneously developed typical gait by 10 years of age and did so without intervention or contractures of the ankle dorsiflexion.

There are a number of reasons some children struggle to walk with a flat foot. freeuse.io

by Monica Jaramillo, Healio Orthopedics Today June 14, 2018

In their previous study of 1,401 Swedish children who were 5.5 years old, researchers found a 5% prevalence of idiopathic toe-walking. In their current study, 26 of the 63 children who were toe-walkers were assessed at 8 and 10 years of age. When children were 8 years old, their parents were asked via telephone if their child received either treatment or diagnosis since their child’s assessment at 5.5 years of age. Parents were asked the same question at their child’s 10-year-old follow-up. The children then underwent a neurological examination and orthopedic examination which focused on the lower extremities.

Results showed six out of the 26 children stopped toe-walking at 8 years of age. By the time children were 10 years old, 50 out of the 63 children spontaneously stopped toe-walking. Investigators noted idiopathic-walking did not lead to contractures of the triceps surae.

One subgroup of children was not considered idiopathic toe-walkers because the children displayed early contracture of the ankle, according to the researchers. There were four children at 10 years old who still toe-waked and demonstrated neurodevelopmental comorbidity.

Idiopathic Toe-Walking: Prevalence and Natural History from Birth to Ten Years of Age, Engström P, Tedroff K. J Bone Joint Surg Am. 2018 Apr 18;100(8):640-647. doi: 10.2106/JBJS.17.00851.

The prevalence and course of idiopathic toe-walking in 5-year-old children, Engström P, Tedroff K. Pediatrics. 2012 Aug;130(2):279-84. doi: 10.1542/peds.2012-0225. Epub 2012 Jul 23.

Source Healio Orthopedics Today

Long-term gait outcomes following conservative management of idiopathic toe walking, Davies K, Black A, Hunt M, Holsti L. Gait Posture. 2018 May;62:214-219. doi: 10.1016/j.gaitpost.2018.02.014. Epub 2018 Feb 14.

Neurodevelopment in preschool idiopathic toe-walkers, P Martín-Casas, R Ballestero-Pérez, A Meneses-Monroy, JV Beneit-Montesinos, MA Atín-Arratibel, JA Portellano-Pérez. Neurología, Volume 32, Issue 7, September 2017, Pages 446-454. doi: 10.1016/j.nrleng.2016.02.006

A functional comparison of conventional knee-ankle-foot orthoses and a microprocessor-controlled leg orthosis system based on biomechanical parameters, Schmalz T, Pröbsting E, Auberger R, Siewert G. Prosthet Orthot Int. 2016 Apr;40(2):277-86. doi: 10.1177/0309364614546524. Epub 2014 Sep 23.

A comparison of orthoses in the treatment of idiopathic toe walking: A randomized controlled trial, Herrin K, Geil M. Prosthet Orthot Int. 2016 Apr;40(2):262-9. doi: 10.1177/0309364614564023. Epub 2015 Jan 27.

The natural history of idiopathic toe-walking: a long-term follow-up of fourteen conservatively treated children, Hirsch G, Wagner B. Acta Paediatr. 2004 Feb;93(2):196-9.

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