Efficacy of Surgery for Idiopathic Toe Walking
Many children walk on their tiptoes. If they continue after age three without a diagnosed medical cause, it's called idiopathic toe walking. For some, surgery to lengthen the Achilles tendon (the cord at the back of the ankle) is performed to help them put their heels down. This small study (a pilot study) is looking into how effective this surgery is for children aged 8 to 16. Researchers want to find out if the surgery improves their walking, strength, how far they can move their foot, and their everyday life. The results from these 20 children will help decide if a bigger study is needed in the future and how it should be organised. Your child's surgery and care would be the same as usual.
At a glance
What is this study about?
When children learn to walk, some naturally go on their tiptoes. However, around 7 out of every 100 children continue to walk this way past the age of three, even when doctors can't find a medical reason for it. This is known as idiopathic toe walking. It can sometimes lead to issues with balance, pain, or make it hard to play certain sports.
For children with idiopathic toe walking who can't comfortably get their heels to touch the floor, surgeons might suggest an operation to lengthen the Achilles tendon. This tendon is located at the back of the ankle and connects the calf muscles to the heel bone. Lengthening it makes it easier for the foot to bend upwards, aiming to help the child walk with their heels down more normally.
However, it's not always clear which children will benefit most from this surgery, and sometimes the improvements don't last. This study wants to understand how helpful this surgery really is. Researchers will look at things like how much the children's walking pattern improves, if they become stronger, how much easier it is to move their foot, and if their overall quality of life gets better after the operation. This is a small, initial study that will help doctors decide if a larger study is needed to get more answers.
Key takeaways
- This study is for children with idiopathic toe walking who are already having Achilles lengthening surgery.
- It aims to see if the surgery improves walking, strength, and quality of life.
- Your child's medical care and surgery will not change if they participate.
- Participation involves filling out questionnaires and a simple leg strength test before and after surgery.
- The study helps doctors understand who benefits most from this surgery.
Who may be eligible?
This study is looking for children aged between 8 and 16 years old. They need to have been diagnosed by a doctor with idiopathic toe walking, meaning there's no other medical condition causing them to walk on their toes. These children must also have a tight Achilles tendon that prevents them from putting their heels flat on the floor.
Importantly, your child must already be scheduled to have surgery to lengthen their Achilles tendon. The study wants to see how well this surgery works for children who are already going to have it.
Children can't take part if they've had surgery on their leg before, or if they have other medical conditions that could cause toe walking, like muscular dystrophy or cerebral palsy. They also won't be able to join if they can't walk continuously for at least 10 metres without help, or if they are waiting for more tests about their toe walking.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- Is your child aged between 8 and 16 years old?
- Has a doctor told you your child has idiopathic toe walking (walking on toes without a known medical reason)?
- Is your child already scheduled to have surgery to lengthen their Achilles tendon?
- Can your child walk at least 10 metres (about the length of two cars) without help?
- Has your child NOT had surgery on their legs before?
- Does your child NOT have other medical conditions that cause toe walking (like cerebral palsy)?
What does participation involve?
If your child takes part, their surgery and hospital care will be exactly the same as if they weren't in the study. You and your child will be asked to fill out some questionnaires, which will have up to 22 questions, before the surgery, then again six months later, and finally one year after the surgery. These questions will help us understand if there have been any changes in their quality of life.
Your child will also do a simple 'single heel-rise test' before their surgery and again one year later. This test helps to check the strength of their leg muscles. The total time your child would be involved with the study will be about one year.
Potential risks and benefits
Locations (2)
- St George's University Hospitals NHS Foundation TrustVerified postcodeTooting, United Kingdom· Recruiting
- Oxford University Hospitals NHS Foundation TrustVerified postcodeOxford, United Kingdom· Recruiting
Common questions
What is idiopathic toe walking?
It's when a child walks on their tiptoes past the age of three, and doctors can't find another medical reason for it.
What is Achilles lengthening surgery?
It's an operation to make the tendon at the back of the ankle a bit longer, helping the child put their heel down more easily.
Will my child's surgery be different if they join the study?
No, your child's surgery and care will be exactly the same as if they were not in the study.
How long will my child be in the study?
They will be part of the study for about one year, with assessments before surgery, and then six months and one year afterwards.
What will my child do in the study?
They will fill out questionnaires and do a simple leg muscle strength test at different times over the year.
How to find out more
Eileen M Morrow, BSc. MSc.
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
Discussion
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