Idiopathic toe-walking in children, adolescents and young adults: a matter of local or generalised stiffness?

Raoul Engelbert, Jan Willem Gorter, Cuno Uiterwaal, Elise van de Putte, Paul Helders, Raoul Engelbert, Jan Willem Gorter, Cuno Uiterwaal, Elise van de Putte, Paul Helders

Abstract

Background: Idiopathic Toe Walking (ITW) is present in children older than 3 years of age still walking on their toes without signs of neurological, orthopaedic or psychiatric diseases. ITW has been estimated to occur in 7% to 24% of the childhood population. To study associations between Idiopathic Toe Walking (ITW) and decrease in range of joint motion of the ankle joint. To study associations between ITW (with stiff ankles) and stiffness in other joints, muscle strength and bone density.

Methods: In a cross-sectional study, 362 healthy children, adolescents and young adults (mean age (sd): 14.2 (3.9) years) participated. Range of joint motion (ROM), muscle strength, anthropometrics sport activities and bone density were measured.

Results: A prevalence of 12% of ITW was found. Nine percent had ITW and severely restricted ROM of the ankle joint. Children with ITW had three times higher chance of severe ROM restriction of the ankle joint. Participants with ITW and stiff ankle joints had a decreased ROM in other joints, whereas bone density and muscle strength were comparable.

Conclusion: ITW and a decrease in ankle joint ROM might be due to local stiffness. Differential etiological diagnosis should be considered.

Figures

Figure 1
Figure 1
Range of joint motion in the ankle joint, between 8 and 20 years of age. P50: Fiftieth percentile. P3: Third percentile. P97: Ninety-seventh percentile.
Figure 2
Figure 2
The association between the amount of dorsal flexion of the ankle joint with the total range of joint motion of the joints of the right upper and lower extremities (without the range of joint motion of the ankle joint).

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Source: PubMed

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