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Does Botulinum toxin A improve the walking pattern in children with idiopathic toe-walking?
Karolinska Institutet, Dept. of Women's and Children's Health.
KTH, School of Engineering Sciences (SCI), Mechanics, Biomechanics. KTH, School of Engineering Sciences (SCI), Mechanics, Structural Mechanics. (Anders Eriksson)ORCID iD: 0000-0001-5417-5939
Karolinska Institutet, Dept. of Women's and Child's Health.
Karolinska Institutet, Dept. of Women's and Children's Health.
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2010 (English)In: Journal of Children's Orthopaedics, ISSN 1863-2521, Vol. 4, no 4, 301-308 p.Article in journal (Refereed) Published
Abstract [en]

Background: Numerous recommendations have been made for treating idiopathic toe-walking (ITW), but the treatment results have been questioned. The purpose of this study was to investigate whether botulinum toxin A (BTX) improves the walking pattern in ITW as examined with 3-D gait analysis. Participants and methods: A consecutive series of 15 children (aged 5-13 years) were enrolled in the study. The children underwent a 3-D gait analysis prior to treatment with a total of 6 units/kg bodyweight Botox® in the calf muscles and an exercise program. The gait analysis was repeated 3 weeks and 3, 6, and 12 months after treatment. A classification of toe-walking severity was made before treatment and after 12 months. The parents rated the perceived amount of toe-walking prior to treatment and 6 and 12 months after treatment. Results: Eleven children completed the 12-month follow-up. The gait analysis results displayed a significant improvement, indicating decreased plantarflexion angle at initial contact and during swing phase and increased dorsiflexion angle during midstance at all post-treatment testing instances. According to the parents' perception of toe-walking, 3/11 children followed for 12 months had ceased toe-walking completely, 4/11 decreased toe-walking, and 4/11 continued toe-walking. After 6-12 months, the toe-walking severity classification improved in 9 of the 14 children for whom data could be assessed. Conclusions: A single injection of BTX in combination with an exercise program can improve the walking pattern in children with ITW seen at gait analysis, but the obvious goal of ceasing toe-walking is only occasionally reached.

Place, publisher, year, edition, pages
2010. Vol. 4, no 4, 301-308 p.
Keyword [en]
3-D gait analysis; Botulinum toxin A; Gait analysis; Habitual toe-walking; Idiopathic toe-walking; Toe-walking
National Category
Orthopedics
Identifiers
URN: urn:nbn:se:kth:diva-74930DOI: 10.1007/s11832-010-0263-9Scopus ID: 2-s2.0-77955054867OAI: oai:DiVA.org:kth-74930DiVA: diva2:490209
Note
QC 20120217Available from: 2012-02-04 Created: 2012-02-04 Last updated: 2012-02-17Bibliographically approved

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Gutierrez-Farewik, Elena

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