Kinesio Taping Effectiveness on Idiopathic Toe Walking

Study Overview
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Brief Summary
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Idiopathic Toe Walking (ITW) is a diagnosis normally of exclusion and likely, consequently, is approached in vastly varying ways of intervention, including serial casting, Botox injections and physical therapy. There is some evidence in the literature that children with ITW can somewhat correct their lack of heel-strike gait pattern at least temporarily. Kinesio Taping (KT) method is an intervention that is used in the outpatient physical therapy setting for various conditions such as post-operative edema, muscle facilitation of weakened rotator cuff muscles, and functional corrections in children with torticollis. This pilot study will strive to determine if KT may be effective by providing proprioceptive and neuromuscular re-education through thermal and mechanical fascial impositions, thereby improving passive joint range of motion (ROM) through reduction of passive muscle stiffness and improving ambulation through neuromuscular re-education in children with idiopathic toe walking. We will quantify passive muscle stiffness of the gastrocnemius and opposing anterior tibialis using non-invasive Shear Wave Elastography (SWE). Further we look at the kinematics and kinetics of the child's ankle during the gait cycle to further determine any effect(s) of KT on functional walking outcome measures. The intent is that the results from this study will serve as a platform from which to expound look at the long-term, if any, effects of KT on the muscle property and gait cycle pattern in children with ITW.

Official Title
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The Effectiveness and Efficacy of Kinesio Taping Method on Muscle Elasticity in Children Who Toe Walk

Conditions
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Idiopathic Toe Walking

Intervention / Treatment
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* Device: Kinesio Tape of the Ankle


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Females and males 3-10 years of age who independently ambulate have a diagnosis of idiopathic toe walking Exclusion Criteria: Children will be excluded if they have a diagnosis of or suspected neuromuscular disorder had prior treatment for ITW including bracing or including splinting in the last six months, chemodenervation, serial casting in the last six months, surgical intervention diagnosis of Autism or Pervasive Developmental Disorder history of allergic reactions to tape/adhesives.

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 10 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Kinesio tape<br> | Device: Kinesio Tape of the Ankle<br>* Tibialis anterior facilitation/ gastrocnemius inhibition: Taping to be worn 3-5 days and repeated x 1<br>* Other names: Kinesio Tape;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Ankle Joint Range of Motion | To evaluate effect of KT on passive ankle ROM, we will measure passive ankle ROM before and after treatment. With the child laying prone, measurements of ankle ROM will be taken using a goniometer with the knee extended and with the knee flexed at 90 degrees. The rationale for this is to differentiate gastrocnemius muscle from soleus muscle, with gastrocnemius contributing to ankle ROM loss when knee is extended because it crosses both joints. | At enrollment, one and two week after kinesio taping | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Advanced gait analysis - Change in kinetics | In children with ITW, gait changes, as measured by ankle kinetics and kinematics, have been shown as toe-walking improves. In ITW, presence of a first ankle rocker, presence of an early third ankle rocker, and predominant early ankle moment on advanced gait analysis are used to classify idiopathic toe walking into three severity groups. Changes to these parameters are used to evaluate effect of treatment on ITW. Therefore, we propose to use these parameters to classify the severity of the ITW before and after KT treatment to evaluate effect of KT on ambulation. | At enrollment, after completion of taping (2-3 weeks after enrollment) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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idiopathic toe walking, gait disorder, gait analysis, kinesio taping, ultrasound elastography, pediatric, children, muscle stiffness, muscle elasticity