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Idiopathic Toe Walking: Part 2

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1.  What does an ITW examination include? Integument/skin condition Neurologic exam Gait All of the above

2.  Which of the statements below are TRUE with regards to over pronation of the foot and ankle? It does not cause breakdown of the midfoot over time. It may produce a falsely large ankle dorsiflexion (DF) PROM measurement. A pronated ankle/foot is efficient during gait. In weight bearing, it is composed of calcaneal inversion and forefoot adduction.

3.  What participation restriction is noted in children with ITW? Decreased ability to ambulate longer distances Difficulty keeping up with peers Lower self-reported quality of life All of the above

4.  Which is NOT considered CONSERVATIVE Management of ITW? Stretching Surgical release of APF/Achilles Tendon Strengthening Shoe modifications

5.  What is a TRUE statement about a surgical release of the APF/Achilles Tendon? It is reserved for older children who have failed to improve ADF KE PROM after conservative interventions or who have significant tightness. It is reserved for younger children only. Children universally stop toe walking after surgery to restore ankle DF PROM. It is used with older children with improved ADF KE PROM.