Idiopathic Toe Walking

Question 1

how to define ITW

Answer 1

Pathological gait pattern on the balls of the feet with no neurological or orthopedic cause.

Question 2

at what age does toe walking become abnormal

Answer 2

after 2

Question 3

what possible factors lead to ITW

Answer 3

MSK abnormalities at ankle/foot
visual processing disorders
altered sensory processing

Question 4

prevalence of ITW

Answer 4

7-24% of healthy children

Question 5

s/s of ITW

Answer 5

bilateral / bilateral equinus 30-60 degrees
limited PROM Dorsiflexion
balance, coordination, falling issues

Question 6

types of toe walking

Answer 6

idiopathic
neurological
sensory

Question 7

where in an exam can a critical distinction be made in a patient with ITW

Answer 7

if they have loss of dorsiflexion or not

Question 8

primary interventions related to ITW

Answer 8

PT
Casting
Botox
Surgery

Question 9

explain PT interventions in those with ITW

Answer 9

stretching of PF muscles/strengthening DF muscles
motor learning
balance

Question 10

explain casting for those with ITW

Answer 10

serial casting
night splints
AFO

Question 11

disadvantage of casting

Answer 11

difficult to regain gait patterns with cast

Question 12

what indicates surgery for those with ITW

Answer 12

triceps surae contracture

Question 13

disadvantage of botox injections

Answer 13

weakened triceps surae

Question 14

what is the goal of PT in those with ITW

Answer 14

stretch gastroc - increase ROM >10 degrees
walking with flat foot > 75% of time