Serial ankle casts for patients with idiopathic toe walking: effects on functional gait parameters

Area of Science:

• Orthopedics
• Pediatric Rehabilitation
• Biomechanics

Background:

• Idiopathic toe walking (ITW) is a common pediatric condition characterized by a lack of heel strike during gait.
• Persistent ITW can lead to musculoskeletal abnormalities and compensatory gait patterns.
• Conservative management strategies are often employed to address ITW.

Purpose of the Study:

• To evaluate the functional impact of serial ankle casting on gait parameters in children with ITW.
• To compare gait analysis outcomes in ITW patients post-treatment with a healthy control group.

Main Methods:

• A prospective, pre-test-post-test control group design was utilized.
• Ten children with ITW underwent serial casting to increase ankle dorsiflexion.
• Functional gait analysis was performed before, after casting, and at a six-month follow-up.

Main Results:

• Serial casting significantly increased normalized plantar heel force and ankle dorsiflexion.
• Muscle activity in the gastrocnemius was reduced by 70%.
• Post-treatment, ITW patients showed no significant gait differences compared to controls at six months.

Conclusions:

• Serial ankle casting effectively lengthens plantar flexors and reduces muscle tone in ITW.
• This leads to sustained improvements in active ankle dorsiflexion and functional gait kinematics.
• The treatment normalizes gait parameters, achieving outcomes comparable to healthy children long-term.