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Updated: Jul 23, 2025
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
Functional Bandaging in Children with Idiopathic Toe-Walking
Deniz Tuncer1, N Ekin Akalan2, M Mine Caliskan3,4
1*Department of Physiotherapy and Rehabilitation, Bezmialem Vakif University, Faculty of Health Sciences, Istanbul, Turkey.
Insights
Functional bandaging improved heel contact and gait quality in children with idiopathic toe-walking (ITW) for a short duration. Further research is needed to confirm long-term effectiveness.
Area of Science:
- Pediatric Orthopedics
- Gait Analysis
- Rehabilitation Medicine
Background:
- Idiopathic toe-walking (ITW) is a gait disorder characterized by absent heel contact during stance.
- The etiology of ITW remains unknown, impacting children's gait patterns.
- Investigating interventions for ITW is crucial for improving mobility and quality of life.
Purpose of the Study:
- To evaluate the efficacy of functional bandaging in improving heel contact during gait in children with ITW.
- To assess the impact of functional bandaging on overall gait quality in children with ITW.
- To determine the immediate and short-term effects of functional bandaging on ITW.
Main Methods:
- A study involving 19 children with ITW and 10 typically developing children.
- Application of elastic adhesive bandages to promote dorsiflexion in children with ITW.
- Gait analysis using pressure sensors and the Edinburgh Visual Gait Score (EVGS) before and after bandaging.
Main Results:
- Children with ITW demonstrated improved heel contact in all stance phases immediately and one week after bandaging.
- Significant improvements in gait quality were observed, as measured by the EVGS.
- While immediate effects were noted, gait parameters showed no significant difference between one week and immediately post-bandaging.
Conclusions:
- Dorsiflexion assistive functional bandaging is effective for improving heel contact and gait quality in children with ITW.
- The therapeutic benefits of functional bandaging appear to be short-term.
- Further research with extended follow-up and larger cohorts is recommended to validate long-term outcomes.
Background:
Idiopathic toe-walking (ITW) is a persistent gait pattern with no known etiology characterized as premature heel rise or no heel contact. We investigated the effects of functional bandaging in children with ITW on heel contact during stance phase and on gait quality.
Methods:
Nineteen children aged 4 to 16 years with ITW and ten age-matched healthy children were included in the study. Elastic adhesive bandages were applied to children with ITW to assist with dorsiflexion. Before bandaging (T0) and immediately (T1) and 1 week (T2) after initial bandaging, the initial contact, loading response, and midstance subphases of gait were analyzed using light pressure sensors and the Edinburgh Visual Gait Score (EVGS). Ten age-matched children with typical gait participated for comparison in T0. The data were analyzed with Friedman and Wilcoxon signed rank tests for within-group comparisons and Mann-Whitney U tests for between-group comparisons.
Results:
In T0, for the ITW group, no heel contact was observed during stance. In T1, all of the participants achieved heel contact at initial contact and loading response and 56.8% at midstance. In T2, all of the heels continued contact at initial contact and loading response and 54.3% at midstance. The EVGS significantly improved. The Friedman test showed that there were noteworthy improvements between T0-T1 and T0-T2 in video-based observational gait analysis and EVGSs (P < .001), although no difference was found between T1-T2 in video-based observational gait analysis (P = .913) and EVGSs (P = .450).
Conclusions:
In children with ITW, dorsiflexion assistive functional bandaging was an effective tool to help achieve heel contact on the ground and improve walking quality for a short period after application. Further studies with longer follow-up and larger sample sizes are required to confirm the long-term therapeutic effects of this promising functional bandaging.
