Toe Walking Flashcards
1
Q
Toe Stepping
A
normal variant occurs in children under 2.5 able to walk with flat feet able to walk on heels bilateral occurs when pull to stand or when change surface
2
Q
Toe Walking
A
atypical
walk on their toes majority of the time
can’t/rarely walk on flat feet
3
Q
Differential Diagnosis - Bilateral VS Unilateral
A
need to rule out a differential diagnosis BILATERAL need to consider - cerebral palsy - Duchenne Muscular Dystrophy - Spinal issues - Charcot Marie Tooth Disease
UNILATERAL need to consider
- cerebral palsy
- DDH
- leg length discrepancy
- nerve idiopathic if unilateral
4
Q
Subjective Ax.
A
Onset - idiopathic if onset with or within 6 mths after onset of walking Change? can they stand on flat feet with prompting Percentage of time spent on their toes general development history family history pain, weakness, tightness? impact on function
5
Q
Objective Ax.
A
no standardised assessment Gait analysis - walking over 10m - measure cadence - toe walkers will have high cadence - percentage of time on toes
Leg length discrepancy
Strength
- full squat without holding on
- how they get off the floor
- hopping
- SL heel raise
Neuro screening - tone
AROM/PROM
gross motor skills
Check sensation and cognition
6
Q
Treatment/Management
A
Conservative
- monitoring purposeful play
- gastroc and soleus stretches
- tib ant strengthening
- gait re-education
- orthotics
Surgery
- tendon lengthening
