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Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
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European Journal of Physical and Rehabilitation Medicine 2014 Oct 09
Treatment outcome of visual feedback training in an adult patient with habitual toe walking
Pelykh O., Klein A.-M., Feist-Pagenstert I., Schlick C., Ilmberger J.
Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Clinics Munich, Germany
BACKGROUND: Habitual (idiopathic) toe walking (HTW) is not a rare diagnosis in pediatric orthopedic patients, but a relative rare pathology in adults. There are no standard recommendations for treating HTW in adult patients.
AIM: To investigate the effects of visual feedback training in an adult patient with habitual toe walking HTW.
DESIGN: case report.
SETTING: Outpatient rehabilitation department.
POPULATION: The 52-year-old woman with HTW.
METHODS: The patient participated in visual feedback training on a treadmill with integrated force plates. A display in front of the patient showed her footprints in synchrony with the treadmill speed so that the patient got dynamic feedback about the pressure of the feet on the ground in real-time on the screen. The training was conducted in 10 sessions of about 40 min within three weeks. Gait analysis (30 sec) and a measurement of the active range of joint motion of the ankle were performed before and after the 3-week treatment period and at follow-up after 3 weeks.
RESULTS: For both feet, contact time of the heel was increased after the training period, whereas contact time of the forefeet decrease. Also positive changes in the active range of joint motion of the ankle (dorsal extension) were observed in both feet. These positive effects were visible also in the follow-up assessment.
CONCLUSIONS: It was shown that providing visual feedback about foot pressure patterns is a promising treatment strategy for adult patients with HTW.