Toe Walking & Orthotic Managment

[Audio] Good Morning Everyone, I am Muhammad Israr. Senior Orthotist Prosthetist at DPRC Dubai Today's Presentation is about to understand Toe Walking and How to treat it with conservative and non surgical approach. Because of the presentation nature i will only focus on Orthotic Managment..

[Audio] Toe walking is a gait abnormality characterized by an absence of normal heel-to-floor contact ( heel strike) by both feet during gait. It is defined as the inability to make heel contact with the floor during the initial stance phase of the gait cycle and the absence of full foot contact with the ground during the remainder of the gait cycle. The forefoot engages in the majority of floor contact throughout the gait cycle. Toe walking has multiple etiologies, ranging from idiosyncratic habit to profound neuromuscular disease. The most commonly observed type of toe walking is idiopathic toe walking ( ITW), which is a diagnosis of exclusion. Toe walking that results from a definable cause (most often neurologic or muscular disease) can be broadly labeled nonidiopathic toe walking ( non-ITW). Identification of non-ITW is critical for determining appropriate treatment and understanding recurrence rates. Although toe walking is commonly seen during development in children who are first learning to walk, a consistent heel-toe pattern of gait usually develops by approximately age 22 months. [ 1, 2] If toe walking persists beyond age 2 years, further evaluation is warranted. [ 3] Treatment depends on the patient's age, the severity of the gait abnormality, and the underlying diagnosis. Specific treatment options range from simple observation to surgical lengthening of muscles or tendons in the lower extremity. Achilles tendon tenotomy is the commonly used procedure for the treatment of toe walking and is one of the oldest procedures in orthopedics. [ 4].