New clinical trial for toe walking

Investigators at Children’s Hospitals and Clinics of Minnesota have received funding for a randomized controlled trial comparing functional outcomes and quality of life between two treatment modalities, serial casting and two-pull carbon fiber solid ankle foot orthotics (AFOs) in children who toe walk. Serial casting has long been used as an effective treatment modality in the treatment of toe walking in patients with an ankle equinus contracture. Observationally at Children’s, two-pull carbon fiber solid AFOs have also been observed to be an effective treatment. Throughout this research study, investigators will be measuring and comparing dorsiflexion range of motion, percentage of time using a heel-toe gait pattern, balance and strength, as well as quality of life.   

Participants placed in the serial casting group will undergo a normal serial casting progression, which typically takes six to eight weeks. If placed in the AFO group, participants will wear braces 23 out of 24 hours of the day with an anticipated treatment duration of 14 weeks. Both groups will participate in a one-hour physical therapy session one time per week and be expected to complete a home exercise program five days per week. Follow up care includes fabrication of non-carbon fiber solid AFOs and continued outpatient physical therapy treatment as per the standard of care.  

Inclusion criteria:

  • Children with bilateral toe walking
  • Children ages 4 to 9 years
  • Children with onset of toe walking since independent ambulation
  • Children with passive dorsiflexion range of motion between -5 to +5 degrees
  • Children and caregivers who are English speaking

For more information please contact the primary investigator of this study,

Nicole Brown, 952-930-8685