Abstract
BackgroundIt is generally understood that toe walking involves the absence or limitation of heel strike in the contact phase of the gait cycle. Toe walking has been identified as a symptom of disease processes, trauma and/or neurogenic influences. When there is no obvious cause of the gait pattern, a diagnosis of idiopathic toe walking (ITW) is made. Although there has been limited research into the pathophysiology of ITW, there has been an increasing number of contemporary texts and practitioner debates proposing that this gait pattern is linked to a sensory processing dysfunction (SPD). The purpose of this paper is to examine the literature and provide a summary of what is known about the relationship between toe walking and SPD.MethodForty-nine articles were reviewed, predominantly sourced from peer reviewed journals. Five contemporary texts were also reviewed. The literature styles consisted of author opinion pieces, letters to the editor, clinical trials, case studies, classification studies, poster/conference abstracts and narrative literature reviews. Literature was assessed and graded according to level of evidence.ResultsOnly one small prospective, descriptive study without control has been conducted in relation to idiopathic toe walking and sensory processing. A cross-sectional study into the prevalence of idiopathic toe walking proposed sensory processing as being a reason for the difference. A proposed link between ITW and sensory processing was found within four contemporary texts and one conference abstract.ConclusionBased on the limited conclusive evidence available, the relationship between ITW and sensory processing has not been confirmed. Given the limited number and types of studies together with the growing body of anecdotal evidence it is proposed that further investigation of this relationship would be advantageous.
Highlights
It is generally understood that toe walking involves the absence or limitation of heel strike in the contact phase of the gait cycle
Only one small prospective, descriptive study without control has been conducted in relation to idiopathic toe walking and sensory processing
A proposed link between idiopathic toe walking (ITW) and sensory processing was found within four contemporary texts and one conference abstract
Summary
It is generally understood that toe walking involves the absence or limitation of heel strike in the contact phase of the gait cycle. When there is no obvious cause of the gait pattern, a diagnosis of idiopathic toe walking (ITW) is made. ITW was first noted in a case review in 1967 [1] and was diagnosed as a congenitally short tendo-achilles This condition is no longer found in the literature; instead reference is made to a clinical condition called habitual, or more recently, idiopathic toe walking (ITW) [2,3,4]. ITW is a diagnosis that can only be made in the absence of any medical condition known to cause toe walking [2,3]. It is noted that having family members who have displayed ITW did not conclusively lead to further generations presenting with this gait type. There is an absence of research into the habitual nature of ITW or the social or familial influences of this gait style and no literature on any influential factors contributing to the initial development of this gait pattern
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