Idiopathic Toe Walking: A Gait Laboratory Review

Idiopathic toe walking (ITW) is defined as one who is neurologically normal but demonstrates a preference for walking on the toes. It is a diagnosis of exclusion so differential diagnoses such as cerebral palsy, neuropathy or myopathy must be ruled out. A review of 102 patients attending a gait laboratory with a presumptive diagnosis of ITW found that gait analysis data agreed with this diagnosis in 81 (79.4%) of cases while the remaining 21 (20.6%) were not typical of this diagnosis. The features found to be significantly different between the groups were Babinski response, fast stretch of the gastrocnemius, knee flexion at initial contact and asymmetry at the ankles during gait. This study highlights that clinical gait analysis can be a useful, non-invasive means of diagnosing idiopathic toe walking and recommending appropriate intervention based on clinical and dynamic assessment of calf tightness.