title: Idiopathic toe-walking: have we progressed in our knowledge of the causality and treatment of this gait type?
abstract: BACKGROUND
  Idiopathic toe-walking (ITW) is a condition commonly seen by podiatric physicians. Because a toe-walking gait style is also caused by or associated with many other medical conditions, podiatric physicians should pay particular attention to ensuring an accurate diagnosis. There are many reported treatment options available for ITW. Therefore, a literature review was conducted to determine what treatment options are supported by the evidence as having the best long-term effect on ITW gait.
  
  
  METHODS
  After extraction of relevant articles, 21 manuscripts reporting treatment options for ITW gait were appraised against the levels of evidence.
  
  
  RESULTS
  From these articles, there was no single treatment option reported as having a long-term effect on the gait of children with ITW. There was support in the literature for surgical interventions, serial casting, and the use of botulinum toxin type A. There was limited evidence that footwear or orthoses changed the gait pattern.
  
  
  CONCLUSIONS
  This review updates the knowledge of podiatric physicians, enhances how children who present with this gait style can be managed, and highlights areas for future research.
authors.forename: Cylie M
authors.initials: CM
authors.lastname: Williams
authors.forename: Paul
authors.initials: P
authors.lastname: Tinley
authors.forename: Barry
authors.initials: B
authors.lastname: Rawicki
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D058996:Quality Improvement; D016059:Range of Motion, Articular / Q000502:physiology*; D014034:Toes; D016896:Treatment Outcome; D016138:Walking / Q000145:classification* / Q000502:physiology