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Neurodevelopment in Preschool Idiopathic Toe-walkers

by MASS4D® Prescription Orthotics July 10, 2018


The purpose of this study was to analyse the neurodevelopmental characteristics of preschool toe-walkers by comparing them to a control group.

For this reason, medical histories of children aged between 3-6 years were collected and a clinical assessment was performed to select the sample.

In the second stage, participants were classified as either toe-walkers or controls.

The toe walking group included those children who had previously been diagnosed with toe walking by a paediatrician, traumatologist, or neurologist, and who displayed a preference for toe walking.

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The control group included those children spontaneously attaining a heel-toe gait.

Neurodevelopment was assessed with the CUMANIN questionnaire (Cuestionario de Madurez Neuropsicológica Infantil), a screening tool validated in Spain which evaluates different areas of a child’s neurological maturation considering his or her chronological age. This helps in providing comprehensive information of a child’s development (cognition, perception, motor function, language, and laterality).

Regarding the initial interview on potential risk factors for toe walking, the only significant intergroup differences the authors found were in family history of toe walking and presence of biological risk factors during the postpartum period.

Circumstances of delivery were also considered with a high frequency of caesarean deliveries and other risk factors associated with delivery in both groups.

Although crawling was the most frequent form of locomotion in both groups, dragging and bottom scooting were found in 11.1% and 4.4% of toe walkers.

The percentage of parents or guardians who perceived motor difficulties in their children was significantly higher in the toe-walking group (59%) than in the control group.

The clinical interview gathered data on risk factors for toe walking. One such factor was a family history of toe walking which was present in 17% of toe walkers in the sample.

The findings of the study proved that toe walkers have specific neurodevelopmental features, supporting the hypothesis that toe walking is a marker of developmental alterations.

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  1. Martín-Cases, P., Ballestero-Pérez, R., Meneses-Monroy, A., Beneit-Montesinos, J.V., Atín-Arratibel, M. A., Portellano-Pérez, J.A. (2017) Neurodevelopment in Preschool Idiopathic Toe-walkers. Neurología: July 2017, Vol. 32, No. 7, pp. 446-454.

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