Even children who are otherwise healthy but who walk on their toes because of spending too much time in baby walkers may be setting themselves up for posture problems in later life, the New Zealand Chiropractors’ Association warns following publication this month of a new study from Sweden.
According to the study to be published in the August issue of Pediatrics as many as one in 20 children may predominantly walk on their toes in early childhood. The study points out that children who have developmental delays or neuropsychiatric disorders are more likely to walk on their toes.
But Dr Hayden Thomas, chiropractor and spokesperson for the New Zealand Chiropractors’ Association explains: Many healthy children also adopt this stance, which can lead to posture problems. Proper motor system integration is often upset by assisted walkers affecting the neuro-musculo-skeletal system. This is jeopardises reflex integration and the development of higher neural function. We strongly advise against the use of baby walkers for New Zealand toddlers for this reason.’
Toe-walking is a condition where children walk on their toes instead of using a typical gait. Certain conditions, such as cerebral palsy, can cause toe-walking, according to background information in the study. But, sometimes, toe-walking occurs in children who appear to be healthy otherwise. This is called idiopathic, or habitual, toe-walking.
The Swedish study noted that toe-walking in otherwise healthy children often resolves on its own. By 5.5 years, "more than half of the children have spontaneously ceased to walk on their toes," they concluded.
Thirty (20 boys and 10 girls) of the otherwise healthy children were current toe-walkers. That represented about 2 per cent of all the children. Another 40 children (22 boys and 18 girls) had previously walked on their toes. That means about 5 per cent of 5.5-year-old children had a history of toe-walking.
Most of the children, but not all, started walking on their toes. Eleven children developed toe-walking during their first year of walking, according to the study. Of the 17 children with developmental delays or neuropsychiatric disorders, seven boys (41 per cent) had a history of toe-walking. About half of these children started walking on their toes. In two children, toe-walking started during the first year of walking, and one youngster started toe-walking during the second year of walking, the researchers found.
Left untreated, toe-walking can cause damage to the structures in the legs, ankles and heels. It can also create a social stigma, according to the study authors.
Commenting on the study, Dr Thomas agreed that every child is different and every treatment is different, but early intervention is key. The brain from zero to 3 years old is much more pliable. He pointed out that children who walk on their toes tend to walk with their stomachs pushed forward, and part of treatment has to include moving that centre of gravity back. And, the longer that posture has been practiced, the longer it will likely take to correct.
Dr Thomas added that while the study found an association between toe-walking and developmental delays or neuropsychiatric disorders, it did not prove a cause-and-effect relationship.
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