Idiophatic toe walkers: sistematic review

Abstract

The idiopathic toe walking march is characterized by the sole support of the forefoot area during the march. It is a disease developed in children from 2 years-age without any neurological or orthopedic impairment. This revisión consists in the comparison of multiple studies including different treatments, such as serial casting, physical therapy, botulinum toxin type A or surgical solutions. The aim is to clarify which of the treatments would be most efficient. The study performed searches of scientific articles on the march in infantile idiopathic toe walking and its treatment in Medline, CINAHL, PubMed, Web of Science and Cochrane Library data base. Two systematic reviews that met the inclusion criteria were selected. After having analysed all results of the different treatments the conclusion is, that there is no difference in effectiveness between them, mainly due to no important difference of treatment. Although there has been no major improvement walking in any of the treatment, the kinetics and the kinematic has improved with all treatments. An increase in the ankle dorsiflexion range of motion was also observed, but only it will be longterm retained in those groups of surgically treated patients. The number of complications that arise after conservative treatment and surgical was minimal. In conclusion we cannot determine which treatment provides more effectiveness promoting the necessity of further studies.