Idiopathic Toe Walking
Conditions
Keywords
Idiopathic Toe Walking, Serial Casting, Exercise
Brief summary
Children who continue to walk on their tiptoes after developing a heel-toe gait normally are diagnosed with idiopathic toe walking (ITW). The study's aim was to investigate the effects of serial casting and physical therapy on joint range of motion (ROM), toe walking severity, functional health and health-related quality of life, walking balance, and satisfaction from treatment in ITW, in comparison with the control group.
Detailed description
Children with ITW aged 3-10 years are randomized into three groups: the serial casting group (n=10), the physical therapy group (n=10), and the wait-list control group (n=10). Patients with ankle contracture and previous interventions are excluded. The serial casting group is planned to receive intermittent serial casting once every three days for three weeks. The physical therapy group is planned to undergo three sessions per week for three weeks, consisting of stretching exercises, strengthening exercises, balance training, proprioception exercises, and walking on heels. The patients were assessed by blinded investigators at before treatment (BT), post-treatment (PT: 3th week), 1st month (1MPT), 3rd months (3MPT), and 6th months post-treatment (6MPT). To ensure ethical considerations, only control group was followed-up until the 1MPT.
Interventions
OTHERSerial Casting
A short leg cast is applied to the serial casting group by an orthopedic specialist once every three days for three weeks.
OTHERExercise
Stretching exercises, strengthening exercises, balance exercises, proprioception exercises, and heel walking exercises are applied to the physical therapy group for 3 weeks with a physiotherapist for 3 sessions a week.
Sponsors
Fatih Sultan Mehmet Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
Randomized, single blinded, controlled study
Eligibility
Sex/Gender
ALL
Age
3 Years to 10 Years
Healthy volunteers
No
Inclusion criteria
1. Aged 3-10 years 2. Patients with idiopathic toe walking diagnosis 3. To be evaluated by a pediatric neurologist, not to have abnormal findings in cranial and all spinal magnetic resonance imaging and electrophysiological examinations performed when deemed necessary, and creatinine kinase values are within normal limits ((Absence of any neurological, orthopedic or psychiatric pathology to explain the toe walking pattern (cerebral palsy, neuropathy, myopathy, autism, developmental disorders, etc.)
Exclusion criteria
1. Have previously conservative or surgical treatment 2. Presence of plantar flexion contracture
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Range of Motion (ROM) | Day 0 | Ankle dorsiflexion ROM with extended knee |
| Toe Walking Severity Scale | Day 0 | The family is asked how long the child tiptoe walks during the day. The evaluation is as follows. Stage 1: Toe walking 76-100% of the time Stage 2: Toe walking 51-75% of the time Stage 3: Toe walking 26-50% of the time Stage 4: Toe walking 10-25% of the time Stage 5: Sole pressing but early heel lift (occasional toe gait \<10%) Stage 6: Normal heel strike |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pediatric Outcomes Data Collection Instrument (PODCI) | Day 0 | PODCI evaluates functional health status through an 86 item questionnaire. Scoring varies greatly due to the multiple weighted scores of some items, scores range from 0-3 for some items and 0-6 for others. The overall score comes from 4 functional assessment scores, a global function score, and a happiness score. These scores range from 0-100 with lower scores representing higher levels of disability. |
| Tandem Walk Test | Day 0 | The participants are asked to walk in a straight line with one foot just in front of the other (heel to toe), arms at their sides. |
| Visual Analog Scale | 3rd week | All participants are asked about satisfaction with treatment through a smiley face visual analog scale 'smiley face' visual analogue scale (0-10, 0 for full satisfaction) |
Countries
Turkey (Türkiye)
Contacts
Primary ContactEsra Giray
Backup ContactÖzge İlleez
Outcome results
None listed