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Dynamic splinting home therapy for toe walking: a case report.

Pamela Lundequam¹, F Buck Willis^2,3

¹Methodist Hospital, Park Nicollet Rehabilitation Services Park Nicollet Blvd, St Louis Park, MN 55416, USA.

|December 1, 2009

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Dynamic splinting combined with physical therapy offers an alternative to serial casting for toe-walking. This approach improved a child's gait and passive dorsiflexion, enabling flat-footed walking.

Area of Science:

Neurology
Pediatrics
Physical Therapy

Background:

Toe-walking is a common gait deviation in children, often treated with serial casting.
Serial casting can limit the continuation of physical therapy (PT) during treatment.
Dynamic splinting (DS) offers a potential alternative for managing toe-walking.

Purpose of the Study:

To describe the outcomes of a child with hemiparesis treated with dynamic splinting (DS) concurrently with physical therapy (PT).
To evaluate the effectiveness of DS and PT in improving gait patterns and ankle mobility in a pediatric patient.

Main Methods:

A case report detailing a child with right hemiparesis and toe-walking gait.
Concurrent treatment involving 4 months of physical therapy (PT) and 6 hours/night of dynamic splinting (DS) as home therapy.

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Assessment of passive dorsiflexion and gait pattern before and after the intervention.

Main Results:

The patient's passive dorsiflexion increased by 14 degrees.
The child achieved the ability to walk with a "flat foot" contact pattern without an ankle-foot orthosis.
Significant improvements in gait pattern and strength were observed.

Conclusions:

Dynamic splinting (DS) combined with physical therapy (PT) is an effective treatment for toe-walking in children with hemiparesis.
This concurrent approach facilitates improved gait and strength training, overcoming limitations associated with traditional serial casting.
DS offers a viable option for home-based therapy complementing in-clinic PT sessions.