9th Excellence in Pediatrics Conference, Vienna, Austria, 7 - 09 December 2017, pp.29
Introduction: The tiptoe walking is diagnosed as idiopathic (habitual) if no signs of neurological,
orthopaedic, or psychiatric disease are detected (for instance, cerebral palsy (CP), Duchenne’s muscular dystrophy, congenitally short Achilles’ tendon, or autism). While it’s not abnormal for children
to walk on their toes for a short period when they first begin to ambulate, prolonged toe walking is
not a component of normal development. The aim of this study was to investigate the effect of combined treatment for a child with Idiopathic tiptoe walking (ITW).
Case Report: A 20 month old boy with ITW who had a positive family history of ITW was admitted to
our hospital. Pathology was not detected in his cranial MR. His family reported that he began to walk
when he was 12 months old. He had no fixed plantar flexion contracture but we examined tightness
his left calf muscles. Facilitation techniques of Kinesio Tape (KT) were applied to left tibialis anterior
muscle three times a week. Soft tissue mobilization (STM) is the application of specific and progressive manual forces with the intent of promoting changes in the myofascia, allowing for elongation
of shortened structures. STM was performed left gastrosoleus muscle group twice a day. In addition
to KT and STM, gentle stretching exercises were taught to his family as a home exercise program to
support the treatment process. Total treatment program lasted 8 weeks. His assessments were
done weekly, by photographs and video recordings, while he is walking bare-foot.
Conclusion: According to the literature it is considered normal for children to walk on their toes until
the age of 2-3. On the other hand early intervention programs are significant in rehabilitation. In our
case we noticed that he could continue tiptoe walking and remain this type of walking as behaviourally. Our results showed that combined treatment with KT and STM had positive results. When video
recordings were compared it was clear that he accomplished walking with a heel strike. Tightness in
his left calf muscles was decreased and muscle tone was normal. According to our results KT and
STM can be used as conservative method for children with ITW. Further studies should be planned
with higher participation rates.