Idiopathic Toe-Walking Position Sensation
Study Details
Study Description
Brief Summary
The aim of this study is to investigate the effect of plantar two-point discrimination on hip-knee-ankle position sense in children with toe walking.The main questions it aims to answer are:
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Are two-point discrimination and light pressure sensation in the plantar region affected in children with idiopathic toe gait?
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Does the two-point discrimination in the plantar in general and the heel in particular affect the position sense of the hip-knee and ankle?
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Children who tend to walk on toes after they should have developed a heel-toe gait are diagnosed with idiopathic toe walking (ITW).Cerebral palsy, muscular dystrophy, and orthopaedic problems such congenital talipes equinus are some of the diseases that are frequently linked to a toe-walking gait. A diagnosis of ITW is made when there is no physical or medical cause for the absence of a heel strike. Five percent of healthy children are estimated to have ITW, and boys are more likely than girls to be affected. Reduced ankle range of motion is prevalent symptom in children with ITW. Since ITW often manifests as symmetrical tiptoe walking in children, reports showing a comparable bilateral reduction in ankle range of motion at both lower limbs indicate the symmetrical character of this gait type. Lower vibration perception thresholds, a tendency to be left-handed, and noticeable variations in sensory seeking and modulation scores are all characteristics of children with an ITW gait.
The small fibers that innervate the cutaneous receptors (such as Merkel's cell, Pacinian corpuscles, Meissner's corpuscles, and Ruffini endings in the skin) are more crucial for postural control than the large fibers that innervate the major muscle spindles and the Golgi tendon organs. Standing balance control is more dependent on Merkel's cells and Ruffini endings (slow adapting receptors), which are in charge of touch and pressure sensitivity, than it is on Meissner's and Pacinian corpuscles (rapid adapting receptors), which are in charge of vibrotactile sensitivity.Additionally, it has been demonstrated that tactile sensation in the foot sole affects the activity of the tibialis anterior muscle as well as the regulation of gait pattern at lower limb joints. These investigations support the notion that cutaneous feeling is crucial for preserving postural and gait stability.The literature states that plantar pressure and sensory changes have disruptive effects on postural control.The aim of this study is to investigate the effect of plantar two-point discrimination on hip-knee-ankle position sense in children with toe walking.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| ITW
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Diagnostic Test: Two-point Discrimination Test
Two-point discrimination (2PD) is the ability to discern that two nearby objects touching the skin are truly two distinct points, not one. It is often tested with two sharp points during a neurological examination and is assumed to reflect how finely innervated an area of skin is.
Diagnostic Test: Semmes-Weinstein monofilament test
Semmes-Weinstein monofilament test is used to assess light touch sensations.
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| Control Group
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Diagnostic Test: Two-point Discrimination Test
Two-point discrimination (2PD) is the ability to discern that two nearby objects touching the skin are truly two distinct points, not one. It is often tested with two sharp points during a neurological examination and is assumed to reflect how finely innervated an area of skin is.
Diagnostic Test: Semmes-Weinstein monofilament test
Semmes-Weinstein monofilament test is used to assess light touch sensations.
|
Outcome Measures
Primary Outcome Measures
- Hip-Knee-Ankle Joint Position Sense [15 weeks]
Position the body segment being tested and then passively position the individual's joint in space. Hold the lateral surfaces of the limb to minimize cues from touch and pressure sensations. Move the body segment into a position and either have the patient maintain the position or assist the patient in maintaining the position if needed. Have the patient duplicate the position with the opposite extremity. The procedure is repeated enough times to conclude if joint position sense is intact or impaired. A suggested minimum number of trials is five per joint.
Eligibility Criteria
Criteria
Inclusion Criteria:
- Having idiopathic toe walking diagnosis
Exclusion Criteria:
- Having another known neuromuscular disease
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Kirsehir Ahi Evran Universitesi
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Silva PG, Jones A, Araujo PM, Natour J. Assessment of light touch sensation in the hands of systemic sclerosis patients. Clinics (Sao Paulo). 2014 Sep;69(9):585-8. doi: 10.6061/clinics/2014(09)02.
- Westberry DE, Davids JR, Davis RB, de Morais Filho MC. Idiopathic toe walking: a kinematic and kinetic profile. J Pediatr Orthop. 2008 Apr-May;28(3):352-8. doi: 10.1097/BPO.0b013e318168d996.
- AEUnivers