DERLEMELER
İdiopatik Parmak Ucunda Yürüme
Idiopathic Toe Walking
Received Date : 01 Oct 2020
Accepted Date : 09 Dec 2020
Available Online : 05 May 2021
Hülya ŞİRZAİa, Emine AHİ DÜNDARb
aClinic of Physical Medicine and Rehabilitation, Liv Hospital Ulus, İstanbul, TURKEY
bClinic of Physical Medicine and Rehabilitation, Private Medar Hospital Gölcük, Kocaeli, TURKEY
Doi: 10.31609/jpmrs.2020-77937 - Makale Dili: EN
J PMR Sci. 2021;24(2):159-63
ÖZET
Parmak ucunda yürüme, ayağın ilk temasında ve yürüme
sırasında topuk temasının olmaması veya yetersizliği olarak
tanımlanır. Parmak ucunda yürüme, serebral palsi, kas distrofisi ve
otizm gibi nörolojik ve nöromusküler hastalıklarda da görülebilmesine
rağmen genellikle neden olacak bir patoloji yoktur. İdiopatik parmak
ucu yürümesi [idiopathic toe walking (ITW)] tanısı için bu
duruma neden olabilecek diğer hastalıklar dışlanmalıdır. ITW,
yaklaşık 20 çocuktan 1’inde görünmektedir. Parmak ucunda yürüyen
çocuklarda denge bozuklukları, sık düşme, ağrı, yorgunluk ve ayak
bileği burkulması meydana gelebilir. Dikkatli bir öykü, fizik muayene
ve bazı durumlarda tanısal testler, parmak ucu yürüme tipini
sınıflandırmaya ve en uygun tedaviyi belirlemeye yardımcı olabilir.
Uzun dönemli takip sonuçlarını gösteren çalışmalar sınırlıdır. Tedavide
takip, fizik tedavi, germe, alçılama, ortez, botulinum toksin
enjeksiyonları ve cerrahi gibi birçok yöntem kullanılmıştır.
Anahtar Kelimeler: Parmak ucunda yürüme; serebral palsi; idiopatik
ABSTRACT
Toe walking is defined as the absence or inadequacy of
heel contact at the first contact of the foot and during walking. Although
toe walking can also be seen in neurological and neuromuscular
diseases such as cerebral palsy, muscular dystrophy and autism, there
is often no pathology to cause. Other diseases that may cause this condition
should be excluded for the diagnosis of idiopathic toe walking
(ITW). ITW had seemed in about one in 20 children. In children walking
on the toes, balance disorders, frequent falls, pain, fatigue are observed
and ankle sprain may occur. A careful history, physical
examination, and in some cases, diagnostic tests can help classify the
type of toe walking and determine the most appropriate treatment. Studies
showing long-term follow-up results are limited. Many treatment
methods such as follow-up, physical therapy, stretching, casting, orthoses,
botulinum toxin injections and surgery have been used.
Keywords: Toe walking; cerebral palsy; idiopathic
REFERENCES
- Caserta AJ, Pacey V, Fahey M, et al. Interventions for idiopathic toe walking. Cochrane Database Syst Rev. 2019;10:CD012363. [Crossref] [PubMed] [PMC]
- Ruzbarsky JJ, Scher D, Dodwell E. Toe walking: causes, epidemiology, assessment, and treatment. Curr Opin Pediatr. 2016;28:40-6. [Crossref] [PubMed]
- Schlough K, Andre K, Owen M, et al. Differentiating between idiopathic toe walking and cerebral palsy: a systematic review. Pediatr Phys Ther. 2020;32:2-10. [Crossref] [PubMed]
- Pomarino D, Ramírez Llamas J, Pomarino A. Idiopathic toe walking: tests and family predisposition. Foot Ankle Spec. 2016;9:301-6. [Crossref] [PubMed]
- Sivaramakrishnan S, Seal A. Fifteen-minute consultation: a child with toe walking. Arch Dis Child Educ Pract Ed. 2015;100:238-41. [Crossref] [PubMed]
- Radtke K, Karch N, Goede F, et al. Outcomes of noninvasively treated idiopathic toe walkers. Foot Ankle Spec. 2019;12:54-61. [Crossref] [PubMed]
- Eastwood DM, Menelaus MB, Dickens DR, et al. Idiopathic toe-walking: does treatment alter the natural history? J Pediatr Orthop B. 2000;9:47-9. [Crossref] [PubMed]
- Oetgen ME, Peden S. Idiopathic toe walking. J Am Acad Orthop Surg. 2012;20:292-300. [Crossref] [PubMed]
- Davies K, Black A, Hunt M, et al. Long-term gait outcomes following conservative management of idiopathic toe walking.Gait Posture. 2018;62:214-9. [Crossref] [PubMed]
- Stott NS, Walt SE, Lobb GA, et al. Treatment for idiopathic toe-walking: results at skeletal maturity. J Pediatr Orthop. 2004;24:63-9. [Crossref] [PubMed]
- de Oliveira VGC, Arrebola LS, de Oliveira PR, et al. Effect of plantar flexor muscle strengthening on the gait of children with idiopathic toe walking: a study protocol. Pediatr Phys Ther. 2019;31:373-8. [Crossref] [PubMed]
- Herrin K, Geil M. A comparison of orthoses in the treatment of idiopathic toe walking: a randomized controlled trial. Prosthet Orthot Int. 2016;40:262-9. [Crossref] [PubMed]
- van Bemmel AF, van de Graaf VA, van den Bekerom MP, et al. Outcome after conservative and operative treatment of children with idiopathic toe walking: a systematic review of literature. Musculoskelet Surg. 2014;98:87-93. [Crossref] [PubMed]
- Fox A, Deakin S, Pettigrew G, et al. Serial casting in the treatment of idiopathic toe-walkers and review of the literature. Acta Orthop Belg. 2006;72:722-30. [PubMed]
- Brunt D, Woo R, Kim HD, et al. Effect of botulinum toxin type A on gait of children who are idiopathic toe-walkers. J Surg Orthop Adv. 2004;13:149-55. [PubMed]
- Williams CM, Michalitsis J, Murphy AT, et al. Whole-body vibration results in short-term improvement in the gait of children with ıdiopathic toe walking. J Child Neurol. 2016;31:1143-9. [Crossref] [PubMed]