Article

OBJECTIVE: To assess the effectiveness of currently available treatment options
for idiopathic toe walking on the 3 main levels of the World Health Organization
International Classification of Functioning, Disability, and Health for Children
and Youth (ICF-CY). DESIGN:
A systematic search from 1966 to December 2013 in
MEDLINE, Current Contents, CINAHL and the Cochrane Library of full-length
articles addressing clinical efficacy of treatment in children aged 2-18 years.
METHODS: Studies were evaluated using both the Oxford Centre for Evidence-Based
Medicine (OCEBM) levels of evidence and the Methodological Index for
Non-Randomised Studies (MINORS). Outcomes were analysed in accordance with the
ICF-CY. RESULTS: One randomized controlled trial and 18 observational studies
were identified. The randomized controlled trial was scored OCEBM level 1,
whereas the other studies were scored level 4. The MINORS scores ranged from 2 to
18. CONCLUSION: There is preliminary evidence for beneficial effects of serial
casting and surgery on passive ankle dorsiflexion as well as on walking kinetics
and kinematics, although normalization does not seem to occur. Botulinum toxin
type A does not improve the results of casting. Only after surgery are
sustainable effects lasting > 1 year reported.
Effectiveness on functional
activities and social participation has yet to be demonstrated.

Langue : ANGLAIS