Idiopathic toe walking

A recent paper published on Medscape suggests that Idiopathic Toe-walking in Children, Adolescents and Young Adults may be due to localised joint stiffness.

Raoul Engelbert; Jan Willem Gorter; Cuno Uiterwaal; Elise van de Putte; Paul Helders

Idiopathic Toe Walking (ITW) is present in children older than 3 years of age still walking on their toes without signs of neurological, orthopaedic or psychiatric diseases.

ITW is thought to occur in about 7% to 24% of the childhood population.

This study was undertaken to determine associations between Idiopathic Toe Walking (ITW) and decrease in range of joint motion of the ankle joint. To study associations between ITW (with stiff ankles) and stiffness in other joints, muscle strength and bone density.

A cross section of 362 healthy children, adolescents and young adults, measuring range of joint motion (ROM), muscle strength, anthropometrics sport activities and bone density.

A prevalence of 12% of ITW was found with nine percent having ITW and severely restricted ROM of the ankle joint.

Children with ITW had three times higher chance of severe ROM restriction of the ankle joint. Participants with ITW and stiff ankle joints had a decreased ROM in other joints, whereas bone density and muscle strength were comparable.

The report concludes that ITW and a decrease in ankle joint ROM might be due to local stiffness. Differential etiological diagnosis should be considered.

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