Physical therapy interventions and treatment for an 11 year old idiopathic toe walker: a case report

Background and Purpose: Idiopathic toe walking is a condition where a person walks on the balls of their feet without any known cause or underlying condition. It is common when children are first learning to ambulate but will typically resolve spontaneously. There is limited evidence for appropriate interventions and a plan of care for an idiopathic toe walker. The purpose of this case study was to show treatment and interventions for an older adolescent idiopathic toe walker. Case Description: The patient is an 11-year-old female with a diagnosis of idiopathic toe walking. The patient has been toe walking since she learned how to ambulate. The chief complaint is pain in the left thigh and low back. Outcomes: The patient had improvements with range of motion, improved mobility, increased hip/core strength and stability, and decrease of pain with functional activities. There was a decrease in pain, from a 7/10 on the initial evaluation to a 1/10. The LEFS improved from a 63/80 to a 69/80. The most notable improvements in ROM were with dorsiflexion, the left foot improved 14 degrees and the right foot improved 12 degrees. The Foot Posture Index remained about the same from initial evaluation.
Discussion: Idiopathic toe walking has been shown to resolve with time, conservative treatment, and surgical intervention. The main challenge with this patient is that she had a flexible gait pattern. The future goal of the patient should be to form a habit to walk with a normal gait pattern instead of on her toes. There is a lack of research involving specific interventions and treatment for idiopathic toe walkers. There is much opportunity to learn in this area about what interventions this patient population would benefit from.