The Prevalence and Course of Idiopathic Toe-Walking in 5-Year-Old Children

• Published in: Pediatrics (Evanston) Vol. 130; no. 2; pp. 279 - 284
• Main Authors: ENGSTRÖM, Pähr, TEDROFF, Kristina
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL American Academy of Pediatrics 01-08-2012
• Subjects: Analysis; Biological and medical sciences; Child; Child Health Services; Child, Preschool; Children & youth; Cognition & reasoning; Cognition disorders; Cognitive disorders; Cohort Studies; Cooperative Behavior; Cross-Sectional Studies; Diagnosis; Epidemiology; Female; Follow-Up Studies; Gait; Gait Disorders, Neurologic - diagnosis; Gait Disorders, Neurologic - epidemiology; General aspects; Health aspects; Humans; Interdisciplinary Communication; Male; Medical sciences; Medicin och hälsovetenskap; Methods; Miscellaneous; Neuropsychology; Pediatrics; Prevalence studies (Epidemiology); Prognosis; Public health. Hygiene; Public health. Hygiene-occupational medicine; Referral and Consultation; Sweden; Toes; Walking; Sweden; United States; Human; Preschool age; Physical exercise; Pediatrics; Prevalence; cognitive disarder; Idiopathic; Cognition; Toe; Epidemiology; idiopathic toe-walking; natural course; Locomotion; Walking; children; Child; Public health
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.2012-0225

Children walking on their toes instead of with a typical gait, without evidence of an underlying medical condition, are defined as idiopathic toe-walkers. The prevalence of idiopathic toe-walking is unknown.
A cross-sectional prevalence study of 5.5-year-old children (n = 1436) living in Blekinge County, Sweden, was performed at the regular 5.5-year visit to the local child welfare center. Children were assessed for a history of toe-walking or whether they still walked on their toes. Additionally, all 5.5-year-old children (n = 35) admitted to the clinic for children with special needs in the county were assessed.
Of the 1436 children in the cohort (750 boys, 686 girls), 30 children (2.1%, 20 boys and 10 girls) still walked on their toes at age 5.5 years and were considered as active toe-walkers. Forty children (2.8%, 22 boys and 18 girls) had previously walked on their toes but had stopped before the 5.5-year visit and were considered as inactive toe-walkers. At age 5.5 years, the total prevalence of toe-walking was 70 (4.9%) of 1436. For children with a neuropsychiatric diagnosis or developmental delay, the total prevalence for active or inactive toe-walking was 7 (41.2%) of 17.
This study establishes the prevalence and- early spontaneous course of idiopathic toe-walking in 5.5-year-old children. At this age, more than half of the children have spontaneously ceased to walk on their toes. The study confirms earlier findings that toe-walking has a high prevalence among children with a cognitive disorder.