Idiopathic Toe Walking in Children
Date of Award
Spring 5-9-2026
Document Type
Thesis
Degree Name
Master of Science in Orthotics and Prosthetics
Department
Kinesiology
Abstract
Abstract
Idiopathic toe walking (ITW) is a gait abnormality that is characterized by persistent toe ambulation without an identified neurological cause or orthopedic condition. Early intervention for the treatment of ITW is crucial to prevent long term complications such as Achilles tendon contractures, gait abnormalities, and balance concerns in children. This study explored optimal timing or orthotic and prosthetic (O&P) intervention for ITW. Participants included 26 children diagnosed with ITW between ages four to 10 years old and 13 healthcare professionals involved in ITW management, including orthotists, prosthetists, pediatricians, and physical therapists. Children were divided into two groups based on intervention timing: an early intervention group (ages 4-5) and a later intervention group (ages 6-10). All pediatric participants received a custom ankle-foot orthosis (AFO) as the primary intervention. Outcome measures included gait parameters recorded using the GAITRite Walkway System, caregiver and clinician responses collected through a modified Toe Walking Tool (TWT) questionnaire, and functional balance assessment using the Pediatric Balance Scale (PBS). Gait variables measured included step length, cadence, and heel strike frequency. The findings suggested earlier intervention before adaptations were identified, improved long term outcomes reducing the need for treatment along with surgical procedures. Additionally, the study emphasized the importance of implementing orthotic management with AFOs within different periods of ages to identify the best optimal timing for intervention with device management and education supporting intervention timing. These insights and findings contributed to making evidence-based decision-making choices to enhance treatment strategies to improve outcomes for children with ITW.