The toe walking extension is an extension to the distal end of a foot orthotic shell to provide a greater dorsiflexion moment at the ankle joint to try and help those with habitual toe walking. Some foot orthotic labs call this a ‘toe walking extension’ and others just have the option to make the foot orthotic shell longer.
There is no strong evidence available as to if this is effective for idiopathic toe walking or not. Michalitsis et al (2019) did show that full length foot orthoses combined with high top boots did affect heel contact time. Herrin & Geil (2016) showed that foot orthoses did not control idiopathic toe walking.
Using a plate or flat sheet of some rigid material like polypropylene or a carbon fiber could be used as a treatment direction test to assess if this toe walking extension on the foot orthotic might be helpful.
This design feature will interfere with normal metatarsophalangeal joint dorsiflexion, potentially affecting the windlass mechanism, so compromises need to be acknowledged if this toe walking extension is used.
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