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Hodgson L, Price C, Reay J, Nester C, Morrison SC. Navigating the integration of knowledge and research evidence in clinical practice for children's foot health: A multi-professional survey. J Foot Ankle Res 2024; 17:e12034. [PMID: 39049500 DOI: 10.1002/jfa2.12034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/10/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Access to clinical services for children with foot and ankle problems are important, but unravelling the complexity of practice and service delivery can be challenging. The pursuit and implementation of research evidence is critical for driving positive change in practice, but little is understood about the approaches to knowledge and research acquisition in children foot health. AIM The aim of the study was to: (1) explore multi-professional habits of knowledge and research evidence acquisition in children's foot health; and (2) understand how clinicians integrate information for children and their families into their practice. METHODS This was a descriptive, cross-sectional online survey. Participants were included if they worked in the UK and had experience of working within paediatric services. RESULTS There were complete responses from 247 health professionals, representing physiotherapists (n = 160), podiatrists (n = 50), orthotists (n = 25), nurses and specialists in community public health nurses (health visitors) (n = 12). Three main themes were generated from the data: (1) Factors that influence knowledge and inform clinical practice. (2) The role of Professional Bodies in informing professional knowledge. (3) Health Professionals' views on managing health information for parents and caregivers. CONCLUSIONS This work advances understanding of the value health professionals' place in the development of materials for informing professional knowledge, as well as highlighting some of the challenges with translation of knowledge into clinical practice. The findings offer a national perspective of health professionals working on children's foot health and have highlighted that some of the most valued influences on clinical practice come from peer-to-peer networking.
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Affiliation(s)
- Lisa Hodgson
- School of Sport and Health Sciences, University of Brighton, Eastbourne, UK
| | - Carina Price
- School of Health and Society, University of Salford, Salford, UK
| | - Julie Reay
- School of Health and Society, University of Salford, Salford, UK
| | - Chris Nester
- School of Health Professions, Keele University, Keele, UK
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Shirel T, Sylvanus T, Cho K, Authement A, Krach LE. Efficacy of serial casting protocols in idiopathic toe-walking. J Pediatr Rehabil Med 2024; 17:179-184. [PMID: 38669491 PMCID: PMC11307011 DOI: 10.3233/prm-230041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/28/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE Idiopathic toe-walking (ITW) is a diagnosis of exclusion. A relationship between ITW and decreased range of motion (ROM) is postulated. Treatments focus on increasing ankle dorsiflexion including serial casting. There is no consensus for duration of serial casting. This study aimed to determine ROM changes with cast change intervals of one vs. two weeks, and the rate of ITW recurrence. METHODS This was a retrospective study of 86 patients, ages 0-9 years with ITW undergoing weekly casting (N = 29) and two-week casting (N = 57) at a children's hospital from 2014-2020. ROM at baseline, two weeks, four weeks, and final cast removal were collected. Statistical analyses included chi-squared tests, two-sample t-tests, and linear mixed regression. Outcome distributions were assessed for normality. P-values < 0.05 were considered statistically significant. RESULTS After adjusting for baseline ROM, the mean change in ROM from baseline to two weeks was 10.6∘ vs 7.5∘ in the one-week vs. two-week casting interval, respectively (p < 0.001). The baseline to final measurement was 13.4∘ vs 9.8∘ in the one-week vs. two-week casting interval, respectively (p < 0.001). The rate of recurrence of ITW was similar between the two groups. CONCLUSION This study suggests greater improvement in ROM in the one-week vs. two-week casting interval group.
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Affiliation(s)
| | | | - Kelly Cho
- Gillette Children’s, Saint Paul, MN, USA
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3
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Brasiliano P, Mascia G, Di Feo P, Di Stanislao E, Alvini M, Vannozzi G, Camomilla V. Impact of Gait Events Identification through Wearable Inertial Sensors on Clinical Gait Analysis of Children with Idiopathic Toe Walking. MICROMACHINES 2023; 14:277. [PMID: 36837977 PMCID: PMC9962364 DOI: 10.3390/mi14020277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
Idiopathic toe walking (ITW) is a gait deviation characterized by forefoot contact with the ground and excessive ankle plantarflexion over the entire gait cycle observed in otherwise-typical developing children. The clinical evaluation of ITW is usually performed using optoelectronic systems analyzing the sagittal component of ankle kinematics and kinetics. However, in standardized laboratory contexts, these children can adopt a typical walking pattern instead of a toe walk, thus hindering the laboratory-based clinical evaluation. With these premises, measuring gait in a more ecological environment may be crucial in this population. As a first step towards adopting wearable clinical protocols embedding magneto-inertial sensors and pressure insoles, this study analyzed the performance of three algorithms for gait events identification based on shank and/or foot sensors. Foot strike and foot off were estimated from gait measurements taken from children with ITW walking barefoot and while wearing a foot orthosis. Although no single algorithm stands out as best from all perspectives, preferable algorithms were devised for event identification, temporal parameters estimate and heel and forefoot rocker identification, depending on the barefoot/shoed condition. Errors more often led to an erroneous characterization of the heel rocker, especially in shoed condition. The ITW gait specificity may cause errors in the identification of the foot strike which, in turn, influences the characterization of the heel rocker and, therefore, of the pathologic ITW behavior.
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Affiliation(s)
- Paolo Brasiliano
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Guido Mascia
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Paolo Di Feo
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Eugenio Di Stanislao
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, 00135 Rome, Italy
- “ITOP SpA Officine Ortopediche”, Via Prenestina Nuova 307/A, 00036 Palestrina, Italy
| | - Martina Alvini
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, 00135 Rome, Italy
- “ITOP SpA Officine Ortopediche”, Via Prenestina Nuova 307/A, 00036 Palestrina, Italy
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Valentina Camomilla
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, 00135 Rome, Italy
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4
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Brasiliano P, Alvini M, Di Stanislao E, Vannozzi G, Di Rosa G, Camomilla V. Effects of wearing a foot orthosis on ankle function in children with idiopathic toe walking during gait. Heliyon 2022; 8:e11021. [PMID: 36281373 PMCID: PMC9587270 DOI: 10.1016/j.heliyon.2022.e11021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Background Idiopathic toe walking (ITW) is a gait deviation characterized by forefoot contact with the ground, possibly enhancing the risk of falling and causing Achilles' tendon shortening and psychological discomfort. Between possible treatments, foot orthosis may limit ITW when worn. With these premises, the effects of a novel foot orthosis (A.Dyn.O.®) on ankle function were analyzed in children with ITW during gait. Methods Twenty-one children were recruited in the study after ITW diagnosis. At follow-up assessment after a habituation period of at least two weeks, participants walked in barefoot condition and while wearing A.Dyn.O.®. Kinetics and kinematics were derived from a multi-segment foot model using an optoelectronic system. Gait spatiotemporal parameters, ankle kinetic and kinematic and rockers timing were analyzed. Lastly, ITW severity was classified according to Alvarez classification. Differences between conditions were verified with paired t-test. Statistical parametric mapping was used to evaluate differences in the entire kinematic and kinetic waveforms. Findings Wearing A.Dyn.O.®, step cadence was reduced, step length, stance phase and stride duration increased; physiological heel rocker was present, thus postponing the timing of ankle and forefoot rockers; ankle dorsiflexion angular excursion, range of motion, maximal dorsiflexor and plantarflexor moments together with maximal power absorption and production were all amplified. Interpretation While wearing it, A.Dyn.O.® limited gait deviations typical of ITW and improved ITW severity classification for most of the participants. These findings suggest that the use of A.Dyn.O.® may assist ITW treatment, preventing children from toe walking and thus limiting its side effects.
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Affiliation(s)
- Paolo Brasiliano
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Rome, Italy,Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Martina Alvini
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Rome, Italy,“ITOP SpA Officine Ortopediche”, Via Prenestina Nuova 307/A, Area Industriale, 00036 Palestrina (RM), Italy
| | - Eugenio Di Stanislao
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Rome, Italy,“ITOP SpA Officine Ortopediche”, Via Prenestina Nuova 307/A, Area Industriale, 00036 Palestrina (RM), Italy
| | - Giuseppe Vannozzi
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Rome, Italy,Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Giuseppe Di Rosa
- Division of Pediatric Neurorehabilitation, “Ospedale Pediatrico Bambino Gesù”, Rome, Italy
| | - Valentina Camomilla
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Rome, Italy,Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy,Corresponding author.
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Donne J, Farrell MJ, Kolic J, Powell J, Fahey M, Williams C. Two-point discrimination responses in children with idiopathic toe walking: A feasibility fMRI study. Sci Prog 2022; 105:368504221132141. [PMID: 36373762 PMCID: PMC10306138 DOI: 10.1177/00368504221132141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Idiopathic toe walking (ITW) is a diagnosis given to children who walk with an absence or limitation of heel strike in the contact phase of the gait cycle, that are otherwise typically developing. There is emerging evidence that this gait pattern may occur in children who experience tactile sensory processing challenges. This feasibility study aimed to determine if children were able to respond to a sensory stimulus during a fMRI. Children aged between 8-16 years of age, with and without idiopathic toe walking were recruited from general public advertising. Participants were required to perform a two-point discrimination test (task block) and press a button without being tested (control block) during an fMRI using a standard block design. Activation differences were examined in the left frontal pole, left supramarginal gyrus, left parahippocampal gyrus, left paracingulate gyrus and the right superior temporal. Five children were in the typically developing (TD) group and three were in the ITW group. There were between-group activation differences in the decision-making block compared to the control block in the left frontal lobe, parahippocampal gyrus and the right superior temporal gyrus. There was greater variation in activation in the left supramarginal gyrus and the left paracingulate gyrus in the ITW group compared to the typically developing group. Based on this study a future sample size of 15 children per group will be required to detect an adequate effect across chosen regions of interest Conducting fMRI using two-point discrimination testing on this population is feasible. Further research is required with larger population sizes to determine if brain activation patterns during the sensory input decision-making process are different in this population.
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Affiliation(s)
- Jack Donne
- School of Primary and Allied Health, Monash University, Frankston, VIC, Australia
| | - Michael J Farrell
- Department of Medical Imaging and
Radiation Sciences, Monash Biomedical Imaging, Clayton, VIC, Australia
| | - Jessica Kolic
- Allied Health, Peninsula Health, Frankston, VIC, Australia
| | - Jennifer Powell
- School of Medicine, The University of
Queensland, Queensland Children's Hospital, Saint Lucia, Australia
| | - Michael Fahey
- Department of Neurology, Monash
Children's Hospital, Clayton, VIC, Australia
| | - Cylie Williams
- School of Primary and Allied Health, Monash University, Frankston, VIC, Australia
- Allied Health, Peninsula Health, Frankston, VIC, Australia
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Caserta A, Reedman S, Morgan P, Williams CM. Physical activity and quality of life in children with idiopathic toe walking: a cross sectional study. BMC Pediatr 2022; 22:544. [PMID: 36100938 PMCID: PMC9472422 DOI: 10.1186/s12887-022-03583-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives To determine if children with idiopathic toe walking (ITW) reach Australian 24-hour movement guidelines. Additional objectives were to identify any factors associated with moderate to vigorous physical activity time of children with ITW. Design Cross sectional. Setting Private practice, public health outpatient, community clinics. Participants Children between 4 and 14 years, who toe walked and had no medical conditions known to cause ITW. Outcome measures Physical activity intensity, sedentary behaviour and sleep data were collected via an ActiGraph. Physical activity level intensity data were triangulated with the Child Leisure Activities Study Survey (CLASS) to highlight the subjective nature of parent-reported measures. Health related quality of life information was collected using the Parent-Proxy and Child-Self Report Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scale. Regression analyses were used to explore individual factors associated with moderate to vigorous physical activity. Results Twenty-seven participants, 17(63%) male, age mean = 6.62 (SD = 2.29) years, provided information on physical activity (CLASS n = 18, ActiGraph n = 22), physical functioning and psychosocial functioning domains on the PedsQL (Parent-Proxy n = 25, Child n = 22). All participants exceeded Australian recommendations for physical activity, 44% (8/18) met recommended screen time amounts, and two (9%) met recommended sleep times. The Child-Self Report PedsQL scale score of social functioning was the only factor associated with an increase in physical activity (Coef = 0.48, 95%CI = 0.09 to 0.87, p = 0.019). Conclusion Participants achieved high levels of daily moderate to vigorous physical activity, and this was associated with social functioning. Given current uncertainty regarding benefits and effectiveness of treatment choices for children who have ITW, these findings should encourage clinicians to consider how their treatment recommendations interact with the PA level and sleep of children with ITW. Any treatment choice should also be implemented with consideration of how it may impact social functioning. This study had a small sample size therefore results should be cautiously interpreted and not generalised to all children with ITW. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03583-w.
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Affiliation(s)
- Antoni Caserta
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, 47 - 49 Moorooduc Hwy, Frankston, VIC, 3199, Australia. .,Monash Health Community, 140-155 Sladen Street, Cranbourne, VIC, 3977, Australia.
| | - Sarah Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Prue Morgan
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, 47 - 49 Moorooduc Hwy, Frankston, VIC, 3199, Australia
| | - Cylie M Williams
- School of Primary and Allied Health Care, Monash University, 47 - 49 Moorooduc Hwy, Frankston, VIC, 3199, Australia
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7
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Valagussa G, Piscitelli D, Baruffini S, Panzeri V, Perin C, Mazzucchelli M, Cornaggia CM, Pellicciari L, Grossi E. Little Evidence for Conservative Toe Walking Interventions in Autism Spectrum Disorders: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00329-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AbstractThis systematic review summarizes the evidence about toe walking (TW) interventions in persons with autism. Following the PRISMA guidelines, a systematic search of MEDLINE, CINAHL, PsycINFO, The Cochrane Library, Google Scholar, and Opengrey was performed. Nine articles (all case reports or case series) were included. Methodological quality was assessed using the Mayo Evidence-Based Practice Centre tool. The included studies considered 17 subjects (16 males; age range: 4–15 years). All studies reported a reduction of TW frequency, but the follow-up was lacking in seven studies. There is a lack of high-quality studies with a sufficiently large and well-characterized sample to assess the effectiveness of TW interventions in autistic persons. These findings strongly support the need for further research in this area.
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8
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Zapata KA, Trevino ME, Reyes FI, Jo CH, Sharma C. Adherence to serial casting protocols for idiopathic toe walking: A quality improvement initiative. J Pediatr Rehabil Med 2022; 15:469-476. [PMID: 36093715 DOI: 10.3233/prm-210054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This initiative aimed to assess adherence to Scottish Rite for Children's serial casting protocol for children with idiopathic toe walking (ITW), factors related to adherence, and outcomes after education regarding the protocol. METHODS 60 patients aged 7.1±2.7 years who completed serial casting were examined at baseline phase (n = 30) and post-education phase (n = 30). Protocols include weekly serial casting for 4 to 6 weeks to achieve 10° of ankle dorsiflexion (ADF) passive range of motion (PROM) with knees extended (KE), assessing the foot posture index (FPI-6) and single leg stance (SLS). Baseline phase evaluated adherence to protocols. Education phase evaluated factors related to adherence and education regarding serial casting findings. Post-education phase evaluated the impact of the education phase. RESULTS Serial casting averaged 4.8±1.5 weeks (n = 60). ADF PROM was measured with 100% adherence. ADF PROM KE averaged -10.7° pre-cast and significantly improved to +6.5° post-cast (n = 60), and it significantly improved post-cast post-education (p = 0.04). FPI-6 and SLS adherence significantly improved post-cast post-education. FPI-6 total score averaged +5.3 at baseline and +5.8 post-cast (n = 35). CONCLUSION Education of staff in serial casting protocols improved adherence and patient outcomes. Patients with ITW and ADF PROM KE -10° benefit from serial casting to improve PROM and to allow for orthotic use post-casting.
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Affiliation(s)
- Karina A Zapata
- Therapy Services, Scottish Rite for Children, Dallas, TX, USA
| | - Megan E Trevino
- Therapy Services, Scottish Rite for Children, Dallas, TX, USA
| | - Fabiola I Reyes
- Neurology and Rehabilitation Medicine, Scottish Rite for Children, Dallas, TX, USA
| | - Chan-Hee Jo
- Research, Scottish Rite for Children, Dallas, TX, USA
| | - Charu Sharma
- Clinical Quality and Performance Improvement, Scottish Rite for Children, Dallas, TX, USA
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9
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De Oliveira V, Arrebola L, De Oliveira P, Yi L. Investigation of Muscle Strength, Motor Coordination and Balance in Children with Idiopathic Toe Walking: A Case-control Study. Dev Neurorehabil 2021; 24:540-546. [PMID: 33759692 DOI: 10.1080/17518423.2021.1899326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To compare muscle strength, ankle dorsiflexion range of motion (ROM), motor coordination and balance, between children with and without Idiopathic Toe Walking (ITW).Materials and methods: This is an observational case-control study. The primary outcome is the triceps surae muscle strength. The secondary outcomes are the anterior tibialis muscle strength, lower limb balance, motor coordination, and ankle dorsiflexion ROM. Thirty-eight children were recruited: 19 between 5 to 11 years old with ITW and 19 healthy (control). Ankle dorsiflexion ROM, triceps surae, anterior tibialis muscle strength, motor coordination, and balance were assessed.Results: Children with ITW showed reduced triceps surae strength [mean difference (MD): 16.2 kgf/kg*100; 95% confidence interval (CI) -32.72 to 0.28; p = .05], reduced anterior tibialis strength (MD: 8.5 kgf/kg*100; 95% CI -13.35 to -3.05; p ≤ 0.001), reduced ankle dorsiflexion ROM (MD: 19.6 degrees; 95% CI 15.43 to 23.77; p ≤ 0.001) and impaired motor coordination and balance (MD: 17.7; 95% CI -25.54 to -9.82; p ≤ 0.001) compared to healthy children.Conclusion: Children with Idiopathic Toe Walking, presented in this study, demonstrated triceps surae and anterior tibialis muscle strength reduction, ankle dorsiflexion ROM reduction, impaired motor coordination, and balance compared to healthy children.
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Affiliation(s)
- Vanessa De Oliveira
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Santos, Brazil.,Physical Therapy Department Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo, Brazil
| | - Lucas Arrebola
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Santos, Brazil.,Physical Therapy Department Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo, Brazil
| | - Pedro De Oliveira
- Physical Therapy Department Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo, Brazil
| | - Liu Yi
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Santos, Brazil
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10
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Berger N, Bauer M, Hapfelmeier A, Salzmann M, Prodinger PM. Orthotic treatment of idiopathic toe walking with a lower leg orthosis with circular subtalar blocking. BMC Musculoskelet Disord 2021; 22:520. [PMID: 34098918 PMCID: PMC8183056 DOI: 10.1186/s12891-021-04327-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is no universally accepted treatment standard for idiopathic toe walking patients (ITW) in the current literature. None of the established methods provide homogenous satisfying results. In our department we treat ITW patients with lower leg orthoses with a circular foot unit for a total of 16 weeks. In this study we reviewed our database to evaluate the success of our treatment protocol for a 24 months follow up period. RESULTS Twenty-two patients were included in this study. Age at the beginning of treatment was 7.0 years +/- 2.9 (range 2.5-13.1). Percentage of ITW at the beginning of treatment according to the perception of the parents was 89% +/- 22.2 (range 50-100). Immediately after the treatment with our device, percentage of ITW dropped to 11% +/- 13.2 (range 0-50). After 12 months, 73% of the patients (16/22) walked completely normal or showed ITW less than 10% of the day. After 24 months, 64% of the patients kept a normal gait (14/22). CONCLUSION This study provides evidence that the treatment of idiopathic toe walking with lower leg orthoses with a circular foot unit results in satisfying long-term results in two thirds of the patients.
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Affiliation(s)
- N Berger
- Children's Orthopaedics, University Hospital Rechts der Isar, Munich, Germany.
| | - M Bauer
- Cand. med, Technical University Munich, Munich, Germany
| | - A Hapfelmeier
- Institute of General Practice and Health Services Research, Technical University of Munich. Institute of Medical Informatics, Statistics and Epidemiology, Technical University of Munich, Munich, Germany
| | - M Salzmann
- Children's Orthopaedics, University Hospital Rechts der Isar, Munich, Germany
| | - P M Prodinger
- Orthopaedics, Krankenhaus Agatharied, Agatharied, Germany
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11
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Williams C, Robson K, Pacey V, Gray K. American and Australian family experiences while receiving a diagnosis or having treatment for idiopathic toe walking: a qualitative study. BMJ Open 2020; 10:e035965. [PMID: 32878753 PMCID: PMC7470490 DOI: 10.1136/bmjopen-2019-035965] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To understand parent journeys while navigating diagnosis, assessment or treatment of their children with idiopathic toe walking (ITW). DESIGN Mixed methods qualitative study: analyses of survey data from the measure of processes of care-20 (MPOC-20) and semistructured interviews were analysed with an interpretative phenomenological analysis approach. Trustworthiness of data was achieved through member checking, researcher triangulation, reflexivity and transferability and comparison with the MPOC-20 results. SETTING USA and Australia. PARTICIPANTS Parents of children diagnosed with ITW who had seen more than one health professional during their care and lived in Australia or the USA. RESULTS Ten parents of children aged between 3 and 13 years and diagnosed with ITW participated. Parents described complex themes relating to their journeys. The themes relating to their journeys were: (1) riding the rollercoaster of diagnosis; (2) navigating the treatment options and (3) supporting parents in the journey. Each theme was supported by parent quotes about their experiences. Challenges were not localised to one country, in spite of vastly different healthcare systems. CONCLUSIONS These findings create opportunities for an international approach to education, treatment recommendations and outcome measures to improve patient and parent experiences. Health professionals should consider the impact on parents in navigating between health professionals when provided with a diagnosis which can have variable outcomes and varied treatment options.
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Affiliation(s)
- Cylie Williams
- Allied Health, Peninsula Health, Frankston, Victoria, Australia
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Kristy Robson
- School of Community Health, Charles Sturt University, Albury, New South Wales, Australia
| | - Verity Pacey
- Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
| | - Kelly Gray
- Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
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