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Effect of Plantar Flexor Muscle Strengthening on the Gait of Children With Idiopathic Toe Walking

A Study Protocol

de Oliveira, Vanessa Gonçalves Coutinho PT; Arrebola, Lucas Simões PT, MSc; de Oliveira, Pedro Rizzi PT; de Sá, Cristina dos Santos PT, PhD; Yi, Liu Chiao PT, PhD

doi: 10.1097/PEP.0000000000000650

Purpose: To evaluate the effect of plantar flexor strengthening associated with conventional physical therapy treatment in participants with idiopathic toe walking.

Methods: Thirty participants, of both sexes diagnosed with idiopathic toe walking, aged 5 and 11 years, will be recruited and randomized into 2 groups: the control group, who will undergo gait training, triceps surae muscle stretching, anterior tibial muscle strengthening, and motor sensory training, and the intervention group, who will undergo the same training as the control group and, additionally, triceps surae muscle strengthening. The intervention will be performed twice a week for 8 weeks. The participants will undergo a 3-dimensional gait kinematic analysis, passive amplitude of dorsiflexion movement, isometric dynamometry of the anterior tibial and triceps surae muscles, motor coordination, quality of life, and perception of the parents regarding the equinus gait at baseline and at the end of treatment. Quality of life will be reevaluated during a 24-week follow-up.

To evaluate the effect of plantar flexor strengthening associated with physical therapy treatment in children with idiopathic toe walking.

Department of Human Movement Science (Ms V. G. C. de Oliveira, Messrs Arrebola and P. R. de Oliveira, and Drs de Sá and Yi), Federal University of Sao Paulo, Santos, Sao Paulo, Brazil; Department of Physical Therapy (Ms V. G. C. de Oliveira and Messrs Arrebola, and P. R. de Oliveira), State Public Server Medical Assistance Institute of São Paulo, São Paulo, Sao Paulo, Brazil.

Correspondence: Liu Chiao Yi, PT, PhD, Department of Human Movement Science, Federal University of Sao Paulo, Rua Silva Jardim 136, Santos, Sao Paulo, Brazil- CEP 11015-020 (

The authors declare no conflicts of interest.

Copyright © 2019 Academy of Pediatric Physical Therapy of the American Physical Therapy Association