Article

Orthotic treatment of idiopathic toe walking is complicated by the
lack of a known etiology. This study compared control of toe walking using an
articulated ankle-foot orthosis versus a rigid carbon fiber footplate attached to
a foot orthosis. OBJECTIVES: Ascertain differences between two orthoses in the
control of idiopathic toe walking. STUDY DESIGN:
Randomized controlled trial.
METHODS: A total of 18 children with idiopathic toe walking were randomized to
either the ankle-foot orthosis or foot orthosis treatment group in a Parallel
Randomized Controlled Trial with no blinding. Prior to and after 6 weeks of
treatment, participants completed three-dimensional gait assessment and the
L-test of Functional Mobility. Parents completed a satisfaction survey and a
subset of the Orthotic and Prosthetic User Survey after treatment. RESULTS: Nine
participants were analyzed in each group. Both groups showed significant
improvement in kinematics versus baseline with orthoses; however, when the
orthoses were removed, the ankle-foot orthosis group did not immediately sustain
this improvement, while the foot orthosis group did. Parents preferred the foot
orthosis for donning and appearance. CONCLUSION: The ankle-foot orthosis controls
idiopathic toe walking, but subjects may revert to earlier patterns following
treatment. The foot orthosis does not control idiopathic toe walking as well but
is less restrictive and more accepted by children and their parents, with similar
out-of-brace effects. CLINICAL RELEVANCE: This study suggests that sequential
orthotic treatment for children with idiopathic toe walking (ITW) may be
beneficial. Initial treatment could include a less restrictive orthosis like a
foot orthosis (FO); if this is unsuccessful within a set time frame, then the
patient may require a more restrictive form of treatment such as an ankle-foot orthosis (AFO).
CI - (c) The International Society for Prosthetics and Orthotics 2015.

Langue : ANGLAIS