THE KINEMATIC PATTERNS OF TOE-WALKERS

Children who toe-walk can pose a diagnostic problem. The differential diagnosis includes mild spastic diplegia and idiopathic toe-walking. C linical differentiation between these two patient groups can be partic ularly difficult, and there are no objective diagnostic tests to assis t the clinician. We assessed 50 children who toe-walk to define the ki nematic patterns of lower-limb joint motion in the sagittal plane. The re were 23 children with mild spastic diplegia, 22 idiopathic toe-walk ers, and five normal children who were asked to toe-walk. We found cha racteristic patterns of knee and ankle motion that differentiated spas tic diplegia from idiopathic toe-walking. Normal children asked to toe -walk had the same pattern as the idiopathic group. Gait analysis is a diagnostic tool that enables the clinician objectively to differentia te mild spastic diplegia from idiopathic toe-walking.