Alvarez C, De Vera M, Beauchamp R, et al: Classification of idiopathic toe walking based on gait analysis: development and application of the ITW severity classification. Gait Posture26: 428, 2007.1716160210.1016/j.gaitpost.2006.10.011)| false
Engelbert R, Gorter JW, Uiterwaal C, et al: Idiopathic toe-walking in children, adolescentents and young adults: a matter of local or generalised stiffness?
BMC Musculoskelet Disord
12: 61, 2011.10.1186/1471-2474-12-61)| false
Hirsch G, Wagner B: The natural history of idiopathic toe-walking: a long-term follow-up of fourteen conservatively treated children. Acta Paediatr93: 196, 2004.1504627310.1111/j.1651-2227.2004.tb00705.x)| false
Armand S, Watelain E, Mercier M, et al: Identification and classification of toe-walkers based on ankle kinematics, using a data-mining method. Gait Posture23: 240, 2006.10.1016/j.gaitpost.2005.02.00716399521)| false
Engström P, Gutierrez-Farewik EM, Bartonek A, et al: Does botulinum toxin A improve the walking pattern in children with idiopathic toe-walking?
J Child Orthop
4: 301, 2010.2180489110.1007/s11832-010-0263-9)| false
Clark E, Sweeney JK, Yocum A, et al: Effects of motor control intervention for children with idiopathic toe walking: a 5-case series. Pediatr Phys Ther22: 417, 2010.2106864210.1097/PEP.0b013e3181f9d5b8)| false
Hallemans A, De Clercq D, Van Dongen S, et al: Changes in foot-function parameters during the first 5 months after the onset of independent walking: a longitudinal follow-up study. Gait Posture23: 142, 2006.
Hallemans A, De Clercq D, Van Dongen S, et al: Changes in foot-function parameters during the first 5 months after the onset of independent walking: a longitudinal follow-up study. Gait Posture23: 142, 2006.10.1016/j.gaitpost.2005.01.00316399509)| false
Bertsch C, Unger H, Winkelmann W, et al: Evaluation of early walking patterns from plantar pressure distribution measurements: first year results of 42 children. Gait Posture19: 235, 2004.10.1016/S0966-6362(03)00064-X15125912)| false
Martín-Casas P, Meneses-Monroy A, Ballestero-Pérez R, et al: Dynamic pedobarographic classification of idiopathic toe-walkers for therapeutical indication. Clínica y Salud28: 17, 2017.10.1016/j.clysa.2016.07.003)| false
Staheli LT, Corbett M, Wyss C, et al: Lower-extremity rotational problems in children: normal values to guide management. J Bone Joint Surg Am67: 39, 1985.396810310.2106/00004623-198567010-00006)| false
Idiopathic toe-walking (ITW) gait may present in children older than 3 years and in the absence of a medical condition known to cause or be associated with toe-walking gait. It is unknown how this gait type changes pressure distribution in the growing foot. We sought to determine whether children with ITW gait exhibit different plantar pressures and temporal gait features than typically developing children.
Children aged 3 to 6 years were recruited who had either a typical heel-toe gait pattern or a diagnosis of ITW. The ITW diagnosis was reported by the parent/caregiver and confirmed through history and physical examination. Temporal gait measures, peak pressures, and impulse percentages were measured. A minimum of ten unshod footprints were collected. Data were compared with unpaired t tests.
The study included 40 children with typical gait and 56 with ITW gait. The ITW group displayed lower peak pressures at the hallux, midfoot, and hindfoot (P < .05) and higher and lower pressure impulse percentages at the forefoot (P < .001) and hindfoot (P < .001), respectively. The ITW group spent a higher percentage of contact time at all areas of the forefoot and less at the midfoot and rearfoot (P < .05). There were no significant differences in total step duration and foot progression angle between groups (P > .05).
There were differences in pressure distributions between groups. Understanding these differences may help us better understand the compensations or potential long-term impact that ITW gait may have on a young child's foot. Podiatric physicians may also consider the use of this equipment in the clinical setting to measure outcomes after treatment for ITW.
Corresponding author: Patricia Martín-Casas, PT, MSc, PhD, Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Plaza de Ramón y Cajal n° 3, Madrid, E-28040 Spain (E-mail: email@example.com)