, vol. 4, issue 4, pp. 142-149, 2015.
Background and purpose: When there is no obvious cause of the gait pattern, a diagnosis of idiopathic toe walking is made. If it is not treated early, it will lead to ankle stiffness and functional problems. So, the purpose of this study was to compare the effects of different treatment options (a designed exercise program, Botulinum Toxin A injection of the calf muscles, Botulinum Toxin A injection of the calf muscles together with a designed exercise program) for idiopathic toe-walking in preschool age children.
Subjects and methods: Forty-five children with idiopathic toe-walking of both sexes (23 boys and 22 girls) were included in this study. Their age ranged from 3.5 to 5 years. They were assigned randomly into three groups of equal number (n= 15). Group I received a designed exercise program, group II received Botulinum Toxin A injection of bilateral calf muscles and the exercise program given to group I while group III received Botulinum Toxin A injection of bilateral calf muscles only. Gait parameters including (stride length, velocity and cadence) and the functional activity were measured by using three dimensional gait analysis and Peabody Developmental Motor Scale-Version 2 respectively. The evaluation was done before treatment (pre), after 3 months of treatment (post 1), after 6 months (post 2) of treatment.
Results: After three months of treatment, significant differences were observed in group II and III (p <0.05) when comparing their pre and post treatment mean values of all measuring variables but when comparing their post treatment mean values, significant differences were recorded in favor of group II (p <0.05). Meanwhile, no significant differences were observed in group I (p > 0.05). After six months, significant improvement was observed in the group I and II (p <0.05) when comparing their post (1) and post (2) mean values, but when comparing their post (2) mean values, significant differences were identified in group II (p <0.05). No significant improvement was observed in group III.
Conclusion: Botulinum Toxin A injection of the calf muscle together with a designed exercise program is an excellent decision for correcting idiopathic toe-walking in preschool age children.
