Idiopathic toe walking

Abstract

Idiopathic toe walking in children is a diagnosis of exclusion. Toe walkers require investigation with a thorough clinical examination, observational gait assessment, and potential additional review to exclude an underlying diagnosis. Threedimensional instrumented gait analysis is helpful to characterize the observed gait pattern and identify children that may benefit from intervention. It is most useful in the child with reduced range of motion at the ankle who has a toe-toe gait pattern but appears to have a heel strike on observational gait analysis. These children often compensate with either hyperextension of the knee in mid-stance, external foot progression, and/or an early heel rise, frequently missed with observational gait analysis. In this clinical scenario, instrumented threedimensional gait analysis enables characterization of the toe walking pattern and identification of objective intervention outcomes.