Foot and Ankle Characteristics of Children with an Idiopathic Toe-Walking Gait

Abstract

Idiopathic toe-walking (ITW) in children has been associated with ankle equinus. Although equinus has been linked to foot deformity in adults, there has been limited investigation of the impact of equinus on structural foot change in children. We used the weightbearing lunge test and the six-item version of the Foot Posture Index (FPI-6) to evaluate the weightbearing foot and ankle measures of children with an ITW gait and to compare these with their age-matched peers. Sixty 4-to 6-year-old children were grouped into ITW (n = 30) and non-toe-walking (n = 30) cohorts using a validated ITW tool. Ankle range of motion was determined with weightbearing lunge tests. The FPI-6 was calculated during weightbearing stance. There was a highly significant difference in the weightbearing lunge test measures between the ITW cohort and the non-toe-walking cohort. The FPI-6 comparison was not significant. The straight-leg lunge test had a statistically significant relationship with the FPI-6 in the ITW cohort. Children with an ITW gait demonstrated reduced flexibility at the ankle joint but similar weightbearing foot posture compared with non-toe-walking children, showing that for children 4 to 8 years old, an ITW gait affects the available ankle dorsiflexion but seems to have a limited effect on weightbearing foot posture as measured by the FPI-6.