Conservative therapy and physiotherapy in children with toe walking: a systematic review


  • Panagiotis Besios Department of Physiotherapy, University of Patras, Patra, Greece
  • Georgios M. Kyriakatis Human Performance and Rehabilitation Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
  • Thomas Besios Human Performance and Rehabilitation Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece



Toe-walking, Botulinum toxin, Ankle foot orthosis, Foot orthosis, Electric stimulation therapy


The purpose of this systematic review was to study all the randomized controlled trials on the effects of conservative treatment and physiotherapy programs on children with toe walking. A literature search was performed in the databases: PubMed, Scopus, PsychInfo, SportDiscus, and ResearchGate. Toe-walking and toe walking were the keywords searched. Furthermore, explicit inclusion and exclusion criteria were established, and the research selection procedure was carried out by two distinct reviewers. The physiotherapy evidence data-base (PEDro) scale was used to assess the quality of the final studies included in the systematic review. Out of the total of 2079 studies initially identified, 6 studies were finally included. The results showed that physiotherapy interventions and conservative therapy, such as botulinum toxin, ankle foot orthosis or foot orthosis and electric stimulation therapy can help reduce toe walking especially when these methods are combined with classic physiotherapeutic exercises and stretches. Conservative treatment and physiotherapy have positive effect on children who have toe walking symptoms. However, further research is needed in this area to determine the most effective treatment methods to reduce the symptoms of toe walking and find the best treatment to improve the daily lives of these patients, focusing on avoiding surgical procedures.


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Systematic Reviews