The Effect of Serial Casting and Physical Therapy in Children With Idiopathic Toe Walking
- Conditions
- Idiopathic Toe Walking
- Interventions
- Other: ExerciseOther: Serial Casting
- Registration Number
- NCT06010485
- Lead Sponsor
- Fatih Sultan Mehmet Training and Research Hospital
- Brief Summary
Children who continue to walk on their tiptoes after developing a heel-toe gait normally are diagnosed with idiopathic toe walking (ITW). The study's aim was to investigate the effects of serial casting and physical therapy on joint range of motion (ROM), toe walking severity, functional health and health-related quality of life, walking balance, and satisfaction from treatment in ITW, in comparison with the control group.
- Detailed Description
Children with ITW aged 3-10 years are randomized into three groups: the serial casting group (n=10), the physical therapy group (n=10), and the wait-list control group (n=10). Patients with ankle contracture and previous interventions are excluded. The serial casting group is planned to receive intermittent serial casting once every three days for three weeks. The physical therapy group is planned to undergo three sessions per week for three weeks, consisting of stretching exercises, strengthening exercises, balance training, proprioception exercises, and walking on heels. The patients were assessed by blinded investigators at before treatment (BT), post-treatment (PT: 3th week), 1st month (1MPT), 3rd months (3MPT), and 6th months post-treatment (6MPT). To ensure ethical considerations, only control group was followed-up until the 1MPT.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 30
- Aged 3-10 years
- Patients with idiopathic toe walking diagnosis
- To be evaluated by a pediatric neurologist, not to have abnormal findings in cranial and all spinal magnetic resonance imaging and electrophysiological examinations performed when deemed necessary, and creatinine kinase values are within normal limits ((Absence of any neurological, orthopedic or psychiatric pathology to explain the toe walking pattern (cerebral palsy, neuropathy, myopathy, autism, developmental disorders, etc.)
- Have previously conservative or surgical treatment
- Presence of plantar flexion contracture
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Exercise Exercise The physical therapy group underwent three sessions per week for three weeks, consisting of stretching exercises, strengthening exercises, balance training, proprioception exercises, and walking on heels. Serial Casting Serial Casting The serial casting group received intermittent serial casting once every three days for three weeks.
- Primary Outcome Measures
Name Time Method Range of Motion (ROM) 27th week Ankle dorsiflexion ROM with flexed knee
Toe Walking Severity Scale 27th week The family is asked how long the child tiptoe walks during the day. The evaluation is as follows.
Stage 1: Toe walking 76-100% of the time Stage 2: Toe walking 51-75% of the time Stage 3: Toe walking 26-50% of the time Stage 4: Toe walking 10-25% of the time Stage 5: Sole pressing but early heel lift (occasional toe gait \<10%) Stage 6: Normal heel strike
- Secondary Outcome Measures
Name Time Method Visual Analog Scale 27th week All participants are asked about satisfaction with treatment through a smiley face visual analog scale 'smiley face' visual analogue scale (0-10, 0 for full satisfaction)
Pediatric Outcomes Data Collection Instrument (PODCI) 27th week PODCI evaluates functional health status through an 86 item questionnaire. Scoring varies greatly due to the multiple weighted scores of some items, scores range from 0-3 for some items and 0-6 for others. The overall score comes from 4 functional assessment scores, a global function score, and a happiness score. These scores range from 0-100 with lower scores representing higher levels of disability.
Tandem Walk Test 27th week The participants are asked to walk in a straight line with one foot just in front of the other (heel to toe), arms at their sides.
Trial Locations
- Locations (1)
Fatih Sultan Mehmet Trainig and Research Hospital
🇹🇷Istanbul, Turkey