Idiopathic toe walking and sensory processing dysfunction

NewsBot · Aug 17, 2010

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Idiopathic toe walking and sensory processing dysfunction
Cylie M Williams email, Paul Tinley email and Michael Curtin
Journal of Foot and Ankle Research 2010, 16 August 2010

Background
It is generally understood that toe walking involves the absence or limitation of heel strike in the contact phase of the gait cycle. Toe walking has been identified as a symptom of disease processes, trauma and/or neurogenic influences. When there is no obvious cause of the gait pattern, a diagnosis of idiopathic toe walking (ITW) is made. Although there has been limited research into the pathophysiology of ITW, there has been an increasing number of contemporary texts and practitioner debates proposing that this gait pattern is linked to a sensory processing dysfunction (SPD). The purpose of this paper is to examine the literature and provide a summary of what is known about the relationship between toe walking and SPD.

Method
Forty-nine articles were reviewed, predominantly sourced from peer reviewed journals. Five contemporary texts were also reviewed. The literature styles consisted of author opinion pieces, letters to the editor, clinical trials, case studies, classification studies, poster/conference abstracts and narrative literature reviews. Literature was assessed and graded according to level of evidence.

Results
Only one small prospective, descriptive study without control has been conducted in relation to idiopathic toe walking and sensory processing. A cross-sectional study into the prevalence of idiopathic toe walking proposed sensory processing as being a reason for the difference. A proposed link between ITW and sensory processing was found within four contemporary texts and one conference abstract.

Conclusion
Based on the limited conclusive evidence available, the relationship between ITW and sensory processing has not been confirmed. Given the limited number and types of studies together with the growing body of anecdotal evidence it is proposed that further investigation of this relationship would be advantageous.
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Admin2 · Aug 17, 2010

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NewsBot · Mar 18, 2018

Do children with attention deficit and hyperactivity disorder (ADHD) have a different gait pattern? Relationship between idiopathic toe-walking and ADHD
Víctor Soto Insuga, Beatriz Moreno Vinués, Rebeca Losada del Pozo, María Rodrigo Moreno, Marta Martínez González, Raquel Cutillas Ruiz, Carmen Mateos Carmen
Anales de Pediatría, 12 March 2018

Introduction
Idiopathic toe-walking (ITW) is described as a gait pattern with no contact between the heels and the ground in children older than 3 years. The diagnosis is clinical, making it necessary to rule out other neurological and orthopaedic conditions. A relationship between ITW and vestibular dysfunction and/or proprioceptive sensibility has been proposed. Children with neurodevelopmental disorders (autism, language and cognitive disorders) often have ITW.

Objectives
To determine the frequency of ITW in children with attention deficit disorder and hyperactivity (ADHD).

Patients and method
A study was conducted on children diagnosed with ADHD, with normal neurological examination, with no alterations in MRI scan, cognitive disorder or autism. A complete clinical anamnesis was performed and Achilles shortening was measured with a goniometer.

Results
The study included 312 children with a mean age of 11 years (73.7% boys). The ADHD combined subtype was the most frequent (53.8%), followed by the inattentive (44.9%), and hyperactive (1.3%). ITW was observed in 20.8% of patients, particularly in the combined subtype (P = .054). Only 32 of them (49.2%) had Achilles shortening. ITW was associated with sociability disorders (P = .01), absence of pain in legs (P = .022), and family history of ITW (P = .004). Only 11% had previously visited a doctor for this reason.

Conclusions
As in other neurodevelopmental disorders, children with ADHD have frequently more ITW and Achilles shortening than controls, especially if they presented with a social communication disorder or a family history of ITW. An early diagnosis is essential to establish effective treatments.
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