December 10, 2016

Toe Walking

How can VIHBRA help in rehabilitation for Toe Walking?

VIHBRA has a special environment for children walking on toes only.

Heel toe shifting is a great exercise for the ankle and calf muscles. During this activity the center of gravity will shift within the limits of stability and can work as an assessment tool.  It will strengthen all muscles of the lower leg, as well as help improve proprioception or balance

toes-pressure-balance

Child is trying to maintain the balance by putting pressure under left/right toe and heel.

What is Toe Walking?

Toe walking is a gait abnormality characterized by an absence of normal heel-to-floor contact (heel strike) by both feet during gait, with the forefoot engaging in the majority of floor contact throughout the gait cycle. Toe walking has multiple etiologies, ranging from idiosyncratic habit to profound neuromuscular disease. Critical to the management of toe walking is the exclusion of neurologic or muscular diseases as a cause of the perceived gait abnormality. Treatment depends on the patient’s age and severity of the gait abnormality. Specific treatment options range from simple observation to surgical lengthening of muscles or tendons in the lower extremity.

Does every toe walking patient/child suffer from a disorder?

More than half of young children who toe walk will stop doing so on their own by about age 5. And most children who are toe walkers will not have any developmental or neuropsychiatric problems, a new study finds.

“Walking is such a notable milestone, and if it is not typical, it is often a concern for parents and physicians,” says pediatrician Lee Beers, MD, who practices at Children’s National Medical Center in Washington, D.C., and who reviewed the study for WebMD. It appears in the journal Pediatrics. “This study certainly makes me feel more comfortable when I see toe walking in children who are otherwise developing well.”

Toe walking can accompany disorders such as cerebral palsy and muscular dystrophy, but it also occurs among children who have no such underlying conditions. In such cases, children are said to be idiopathic toe walkers.

The cause is unknown, lead author Pahr Engstrom, MD, of the Karolinska Institutet in Stockholm, says in an email.

It could be related to nerves, muscles, a mixture of both, or another unknown factor, he says.

Toe walking is sometimes the result of cerebral palsy, muscular dystrophy or another generalized disease of nerve and muscle. Children with autism also may walk on their toes or the balls of their feet, but many do not.