Idiopathic toe walking in children and adolescents
Keywords:Achilles tendon, equinus deformity, gait disorders, pediatric age
Toe walking has an estimated incidence of 7-24% in the general pediatric population and is a frequent cause of referral to outpatient pediatric neurology. Idiopathic toe walking occurs in healthy children without spasticity and normal osteotendinous reflexes, is evident from the beginning of independent gait and always bilateral and not progressive. The etiology is unknown, so it is a diagnosis of exclusion. Thus, in evaluating these children is essential to be alert to sensory or motor signs because this gait pattern may be the first sign of pathologies such as cerebral palsy, congenital muscular dystrophy or autism spectrum disorder. Therapeutic options include more conservative treatments such as physiotherapy, use of orthopedic footwear, splints or orthotics; or more invasive treatments such as use of serial casts, botulinum toxin or surgery.
The aim of this article is: to address epidemiological and pathophysiological aspects, review the clinical presentation and differential diagnosis and propose guidelines for the monitoring and treatment of idiopathic toe walking in pediatric age.
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