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Sixty idiopathic toe walkers (age range 1 to 15 years) were evaluated to determine the natural history of toe-to-toe gait and the relationship between the range of ankle dorsiflexion and increasing age. The majority of toe walkers had a normal birth weight (average 7.06 pounds), walked on time (average 11.14 months), began toe walking immediately (87%), stood plantigrade (90%), were able to demonstrate a heel-toe gait (88%), and toe walked intermittently (68%). Forty-six percent of all toe walkers were found to have 0 degree or less of passive ankle dorsiflexion. Equinus toe walkers (mean dorsiflexion -5.2 degrees) had significantly less dorsiflexion than the remaining toe walkers (mean dorsiflexion 16.9 degrees; p < 0.01). An average of 12 degrees of dorsiflexion was resent in the 1-to 2-year age group, which gradually diminished to -4 degrees in the 6- to 15-year age group. It appears that there may be a relationship between persistent toe walking and the development of ankle equinus in some children and therefore interventions should be considered to inhibit the toe walking progression.
The effect of a magnetic foil placed in the PPT/Rx Firm Molded Insole on the relief of heel pain was determined using the foot function index. Nineteen patients wore the PPT/Rx Firm Molded Insoles with the magnetic foil for 4 weeks and 15 patients wore the same PPT/Rx Firm Molded Insole with no magnetic foil for the same time. Approximately 60% of patients in both groups reported improvement. There was also no significant difference in the improvement between the magnetic foil group and the PPT/Rx Firm Molded Insole group in their scores on the post-treatment foot function index. These results suggest that the PPT/Rx Firm Molded Insole alone was effective in treating heel pain after only 4 weeks. The magnetic foil offered no advantage over the plain insole.
A clinical study was performed to evaluate the efficacy of the Viscoped Insole as compared with an 1/8-inch PORON medical materials insole in the treatment of lesser submetatarsal hyperkeratotic callosities. Thirty-five patients, ranging in age from 23 through 61 years (average 42 years) were randomly divided into three groups. All three groups initially had debridement of their submetatarsal callosities. In addition to the debridement, the first group (16 patients) wore a Viscoped Insole for 4 weeks. The patients in the second group wore a PORON insole for 4 weeks. The third group did not receive an insole after their debridement and served as the control. There was a significant improvement in the Viscoped group and the PORON group versus the control group (x2 = 40; p < 0.01) as measured by the foot function index. Insole therapy combined with debridement for submetatarsal hyperkeratoses is more effective than debridement alone.
