Efficacy of Non-Surgical versus Surgical Treatments for Toe Walking in Children with Autism Spectrum Disorder: A Systematic Review

Overview

This systematic review evaluates the efficacy of conservative and surgical treatments for toe walking in children with Autism Spectrum Disorder (ASD). The findings indicate that conservative treatments generally report higher improvement rates compared to surgical approaches, although the evidence is of very low certainty.

Background

Toe walking is a common gait abnormality in children with Autism Spectrum Disorder (ASD), potentially linked to sensory and motor dysfunctions. It can lead to musculoskeletal complications. Understanding effective treatment options is crucial for improving outcomes in this population.

Data Highlights

The review included eight studies with a total of 424 ASD patients aged 2–16 years. Conservative treatments showed numerically higher improvement rates compared to surgical interventions, but findings were based on heterogeneous outcome measures.

Key Findings

• Toe walking is observed in 41%-68% of children with ASD, according to existing literature.
• Conservative treatments generally reported higher improvement values than surgical approaches.
• The evidence regarding treatment effectiveness is of very low certainty.
• Further high-quality studies with standardized outcomes are needed.
• Persistent toe walking may lead to musculoskeletal complications such as Achilles tendon shortening.

Clinical Implications

Clinicians should consider a range of conservative treatment options for toe walking in children with ASD, as these may yield better outcomes than surgical interventions. Ongoing assessment and tailored rehabilitation plans are essential to address individual needs.

Conclusion

The review highlights the current low certainty of evidence regarding effective treatment strategies for toe walking in children with ASD.

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