Children who continue to walk on their tiptoes after developing a heel-toe gait normally are diagnosed with idiopathic toe walking (ITW). The study's aim was to investigate the effects of serial casting and physical therapy on joint range of motion (ROM), toe walking severity, functional health and health-related quality of life, walking balance, and satisfaction from treatment in ITW, in comparison with the control group.
Children with ITW aged 3-10 years are randomized into three groups: the serial casting group (n=10), the physical therapy group (n=10), and the wait-list control group (n=10). Patients with ankle contracture and previous interventions are excluded. The serial casting group is planned to receive intermittent serial casting once every three days for three weeks. The physical therapy group is planned to undergo three sessions per week for three weeks, consisting of stretching exercises, strengthening exercises, balance training, proprioception exercises, and walking on heels. The patients were assessed by blinded investigators at before treatment (BT), post-treatment (PT: 3th week), 1st month (1MPT), 3rd months (3MPT), and 6th months post-treatment (6MPT). To ensure ethical considerations, only control group was followed-up until the 1MPT.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
30
A short leg cast is applied to the serial casting group by an orthopedic specialist once every three days for three weeks.
Stretching exercises, strengthening exercises, balance exercises, proprioception exercises, and heel walking exercises are applied to the physical therapy group for 3 weeks with a physiotherapist for 3 sessions a week.
Fatih Sultan Mehmet Trainig and Research Hospital
Istanbul, Turkey (Türkiye)
Range of Motion (ROM)
Ankle dorsiflexion ROM with extended knee
Time frame: Day 0
Range of Motion (ROM)
Ankle dorsiflexion ROM with extended knee
Time frame: 3rd week
Range of Motion (ROM)
Ankle dorsiflexion ROM with extended knee
Time frame: 7th week
Range of Motion (ROM)
Ankle dorsiflexion ROM with extended knee
Time frame: 15th week
Range of Motion (ROM)
Ankle dorsiflexion ROM with extended knee
Time frame: 27th week
Range of Motion (ROM)
Ankle dorsiflexion ROM with flexed knee
Time frame: Day 0
Range of Motion (ROM)
Ankle dorsiflexion ROM with flexed knee
Time frame: 3rd week
Range of Motion (ROM)
Ankle dorsiflexion ROM with flexed knee
Time frame: 7th week
Range of Motion (ROM)
Ankle dorsiflexion ROM with flexed knee
Time frame: 15th week
Range of Motion (ROM)
Ankle dorsiflexion ROM with flexed knee
Time frame: 27th week
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Toe Walking Severity Scale
The family is asked how long the child tiptoe walks during the day. The evaluation is as follows. Stage 1: Toe walking 76-100% of the time Stage 2: Toe walking 51-75% of the time Stage 3: Toe walking 26-50% of the time Stage 4: Toe walking 10-25% of the time Stage 5: Sole pressing but early heel lift (occasional toe gait \<10%) Stage 6: Normal heel strike
Time frame: Day 0
Toe Walking Severity Scale
The family is asked how long the child tiptoe walks during the day. The evaluation is as follows. Stage 1: Toe walking 76-100% of the time Stage 2: Toe walking 51-75% of the time Stage 3: Toe walking 26-50% of the time Stage 4: Toe walking 10-25% of the time Stage 5: Sole pressing but early heel lift (occasional toe gait \<10%) Stage 6: Normal heel strike
Time frame: 3rd week
Toe Walking Severity Scale
The family is asked how long the child tiptoe walks during the day. The evaluation is as follows. Stage 1: Toe walking 76-100% of the time Stage 2: Toe walking 51-75% of the time Stage 3: Toe walking 26-50% of the time Stage 4: Toe walking 10-25% of the time Stage 5: Sole pressing but early heel lift (occasional toe gait \<10%) Stage 6: Normal heel strike
Time frame: 7th week
Toe Walking Severity Scale
The family is asked how long the child tiptoe walks during the day. The evaluation is as follows. Stage 1: Toe walking 76-100% of the time Stage 2: Toe walking 51-75% of the time Stage 3: Toe walking 26-50% of the time Stage 4: Toe walking 10-25% of the time Stage 5: Sole pressing but early heel lift (occasional toe gait \<10%) Stage 6: Normal heel strike
Time frame: 15th week
Toe Walking Severity Scale
The family is asked how long the child tiptoe walks during the day. The evaluation is as follows. Stage 1: Toe walking 76-100% of the time Stage 2: Toe walking 51-75% of the time Stage 3: Toe walking 26-50% of the time Stage 4: Toe walking 10-25% of the time Stage 5: Sole pressing but early heel lift (occasional toe gait \<10%) Stage 6: Normal heel strike
Time frame: 27th week
Pediatric Outcomes Data Collection Instrument (PODCI)
PODCI evaluates functional health status through an 86 item questionnaire. Scoring varies greatly due to the multiple weighted scores of some items, scores range from 0-3 for some items and 0-6 for others. The overall score comes from 4 functional assessment scores, a global function score, and a happiness score. These scores range from 0-100 with lower scores representing higher levels of disability.
Time frame: Day 0
Pediatric Outcomes Data Collection Instrument (PODCI)
PODCI evaluates functional health status through an 86 item questionnaire. Scoring varies greatly due to the multiple weighted scores of some items, scores range from 0-3 for some items and 0-6 for others. The overall score comes from 4 functional assessment scores, a global function score, and a happiness score. These scores range from 0-100 with lower scores representing higher levels of disability.
Time frame: 3rd week
Pediatric Outcomes Data Collection Instrument (PODCI)
PODCI evaluates functional health status through an 86 item questionnaire. Scoring varies greatly due to the multiple weighted scores of some items, scores range from 0-3 for some items and 0-6 for others. The overall score comes from 4 functional assessment scores, a global function score, and a happiness score. These scores range from 0-100 with lower scores representing higher levels of disability.
Time frame: 7th week
Pediatric Outcomes Data Collection Instrument (PODCI)
PODCI evaluates functional health status through an 86 item questionnaire. Scoring varies greatly due to the multiple weighted scores of some items, scores range from 0-3 for some items and 0-6 for others. The overall score comes from 4 functional assessment scores, a global function score, and a happiness score. These scores range from 0-100 with lower scores representing higher levels of disability.
Time frame: 15th week
Pediatric Outcomes Data Collection Instrument (PODCI)
PODCI evaluates functional health status through an 86 item questionnaire. Scoring varies greatly due to the multiple weighted scores of some items, scores range from 0-3 for some items and 0-6 for others. The overall score comes from 4 functional assessment scores, a global function score, and a happiness score. These scores range from 0-100 with lower scores representing higher levels of disability.
Time frame: 27th week
Tandem Walk Test
The participants are asked to walk in a straight line with one foot just in front of the other (heel to toe), arms at their sides.
Time frame: Day 0
Tandem Walk Test
The participants are asked to walk in a straight line with one foot just in front of the other (heel to toe), arms at their sides.
Time frame: 3rd week
Tandem Walk Test
The participants are asked to walk in a straight line with one foot just in front of the other (heel to toe), arms at their sides.
Time frame: 7th week
Tandem Walk Test
The participants are asked to walk in a straight line with one foot just in front of the other (heel to toe), arms at their sides.
Time frame: 15th week
Tandem Walk Test
The participants are asked to walk in a straight line with one foot just in front of the other (heel to toe), arms at their sides.
Time frame: 27th week
Visual Analog Scale
All participants are asked about satisfaction with treatment through a smiley face visual analog scale 'smiley face' visual analogue scale (0-10, 0 for full satisfaction)
Time frame: 3rd week
Visual Analog Scale
All participants are asked about satisfaction with treatment through a smiley face visual analog scale 'smiley face' visual analogue scale (0-10, 0 for full satisfaction)
Time frame: 7th week
Visual Analog Scale
All participants are asked about satisfaction with treatment through a smiley face visual analog scale 'smiley face' visual analogue scale (0-10, 0 for full satisfaction)
Time frame: 15th week
Visual Analog Scale
All participants are asked about satisfaction with treatment through a smiley face visual analog scale 'smiley face' visual analogue scale (0-10, 0 for full satisfaction)
Time frame: 27th week