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Case Studies: Toe Walking

If children are learning to walk, they should quickly stop tip-toe walking within a few weeks. There can be a variety of contributing factors for why a child might continue to toe walk.

Unresolved toe walking can result in:

  •  Tight muscles in the legs
  •  Impaired walking or running
  •  Pain in the legs
  •  Increased risk of tripping and falling

Case Study 1

  • 7-year-old male
  • Autism Spectrum Disorder diagnosis
  • Tip-toe walked since started walking
  • -25 degrees for plantar flexion on B ankles at evaluation
  • Seven (7) weeks of occupational therapy
  • Five (5) months of aquatic physical therapy, including a five days per week walking program
  • Achieved heel contact in stance in pool
  • Improved tolerance of shoe wear and improved walking tolerance/attention

Case Study 2

  • 5-year-old female
  • Autism Spectrum Disorder diagnosis
  • Tip-toe walked since started walking
  • Mother expressed concerns for tip-toe walking for falls
  • Full ROM for plantar and dorsiflexion
  • Therapist discussed toe walking program, but trialed reflex integration as a modality first
  • Within one week of mother consistently doing home exercise program two times per day, patient had decreased tip-toe walking by 75%, per parent report
  • No need to complete toe walking program at this time

For additional information on Good Shepherd Pediatrics’ toe walking services, contact Jennifer Schueck-Plominski, MS, OTR/L, at 610-737-4037 or [email protected].