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Published on: March 4, 2018
The prevalence and course of idiopathic toe-walking in 5-year-old children
Pähr Engström1, Kristina Tedroff
1Karolinska Institutet, Department of Paediatric Orthopaedics, Astrid Lindgren Children's Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden. pahr.engstrom@ki.se
Insights
Idiopathic toe-walking affects 4.9% of 5.5-year-olds, with over half resolving spontaneously. Children with cognitive disorders show a higher prevalence of this gait pattern.
Area of Science:
- Pediatrics
- Gait Analysis
- Developmental Pediatrics
Background:
- Idiopathic toe-walking is characterized by children walking on their toes without an underlying medical cause.
- The prevalence of idiopathic toe-walking has not been previously established.
Purpose of the Study:
- To determine the prevalence of idiopathic toe-walking in 5.5-year-old children.
- To investigate the spontaneous resolution rate of toe-walking by age 5.5.
Main Methods:
- A cross-sectional study involving 1436 children aged 5.5 years in Blekinge County, Sweden.
- Children were assessed for current or past toe-walking at routine child welfare center visits.
- Included an additional assessment of 35 children with special needs.
Main Results:
- The prevalence of active idiopathic toe-walking was 2.1% (30 children).
- The prevalence of inactive idiopathic toe-walking (previously toe-walkers) was 2.8% (40 children).
- Overall toe-walking prevalence was 4.9% (70 children); 41.2% of children with special needs exhibited toe-walking.
Conclusions:
- Idiopathic toe-walking is common in 5.5-year-old children, with a significant proportion ceasing spontaneously.
- The study provides prevalence data and insights into the natural course of idiopathic toe-walking.
- Confirms a higher prevalence of toe-walking in children with cognitive disorders.
Background:
Children walking on their toes instead of with a typical gait, without evidence of an underlying medical condition, are defined as idiopathic toe-walkers. The prevalence of idiopathic toe-walking is unknown.
Methods:
A cross-sectional prevalence study of 5.5-year-old children (n = 1436) living in Blekinge County, Sweden, was performed at the regular 5.5-year visit to the local child welfare center. Children were assessed for a history of toe-walking or whether they still walked on their toes. Additionally, all 5.5-year-old children (n = 35) admitted to the clinic for children with special needs in the county were assessed.
Results:
Of the 1436 children in the cohort (750 boys, 686 girls), 30 children (2.1%, 20 boys and 10 girls) still walked on their toes at age 5.5 years and were considered as active toe-walkers. Forty children (2.8%, 22 boys and 18 girls) had previously walked on their toes but had stopped before the 5.5-year visit and were considered as inactive toe-walkers. At age 5.5 years, the total prevalence of toe-walking was 70 (4.9%) of 1436. For children with a neuropsychiatric diagnosis or developmental delay, the total prevalence for active or inactive toe-walking was 7 (41.2%) of 17.
Conclusions:
This study establishes the prevalence and- early spontaneous course of idiopathic toe-walking in 5.5-year-old children. At this age, more than half of the children have spontaneously ceased to walk on their toes. The study confirms earlier findings that toe-walking has a high prevalence among children with a cognitive disorder.
