Idiopathic Toe Walking and ADHD

Article source: Your Therapy Source

Recent research examined the relationship between idiopathic toe walking and ADHD. Idiopathic toe walking was defined as a gait pattern with no contact between the heels and the ground in children older than three years. The study included 312 children diagnosed with ADHD, with a normal neurological examination, with no alterations in MRI scan, cognitive disorder, or autism. A complete medical history and goniometric measurements were obtained for each of the participants (mean age 11 years old, 73.7% boys). The participants were classified according to ADHD subtypes:

  • 53.8% had ADHD combined subtype
  • 44.9% had inattentive ADHD
  • 1.3% had hyperactive ADHD

The results of the study on idiopathic toe walking and ADHD indicated the following:

  • Idiopathic toe walking was observed in 20.8% of patients, mostly in the combined subtype.
  • Achilles shortening was present in 49.2% of the participants with idiopathic toe walking.
  • Idiopathic toe walking was associated with sociability disorders, an absence of pain in legs, and a family history of toe walking.
  • 11% of the participants had visited a doctor for toe walking.

The researchers concluded that children with ADHD have an increase in idiopathic toe walking and Achilles shortening, especially if they presented with a social communication disorder or a family history of toe walking. It is helpful when idiopathic toe walking is diagnosed early to begin effective treatments.

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Torticollis & Plagiocephaly

What is Torticollis & Plagiocephaly?

Torticollis is defined as a muscular tightness in the muscles on one side of the neck.

The Sternocleidomastoid muscle is most commonly affected. Muscles on the opposite side of the affected side may become weak due to the abnormal head posture. The most optimal time to begin Physical Therapy for Torticollis is between 2 weeks to 2 months of age. However, we evaluate babies at any age when a head tilt is observed. Early diagnosis and treatment is the key to success.

With Right Torticollis, the baby’s head will typically look tilted toward the right shoulder and rotated toward the left shoulder.

With Left Torticollis, the baby’s head will typically look tilted toward the left shoulder and rotated toward the right shoulder.

Plagiocephaly is defined as an abnormal head shape or flat head syndrome.

Plagiocephaly is characterized by a flattening on the back of the skull or on one side of the skull. It can occur before or after birth and can be due to abnormal positioning in utero, prematurity, or from lying on the back or on one side of the head for too long after birth due to decreased tummy time. This condition can also be caused by overuse of a car seat, stroller, bouncer seat or swing. There is often some facial asymmetry seen. An abnormal head shape continuing beyond six weeks of age should be evaluated.

We have developed and teach a specially developed Torticollis Protocol. Parents are given a comprehensive home exercise program including handouts. Instructions are given for stretching, strengthening, and positioning during carrying, feeding and playing activities. Parents are encouraged to take pictures and videotape sessions for home carryover.

The purpose and goals of early Physical Therapy treatment for Torticollis are to:

  • Stretch the involved muscles of the neck
  • Strengthen the weakened/opposite muscles of the neck
  • Promote proper and symmetrical development of the baby
  • Promote age-appropriate developmental activities

Early recognition and treatment are important to facilitate proper elongation of the muscles and achieve the above-mentioned goals. The earlier we evaluate and treat these babies, the faster the positive results.