Stepping Towards Solutions: A Toe-walking Study at Shriners Children's

Research is a core pillar of the Shriners Children’s mission. Our specialists believe in progress, innovation, and finding the best solutions for our patients. A multi-center research initiative is now underway aimed at enhancing the lives of children who face challenges with toe-walking.

Led by Jeremy Bauer, M.D., an orthopedic surgeon at Shriners Children's Portland, this study is a testament to our healthcare system’s commitment to providing the highest quality specialty pediatric orthopedic care. Specialists are enrolling children at eight Shriners Children’s locations across the country, and patients are invited to take part in this groundbreaking research opportunity.

Understanding the Study

Toe-walking is common in toddlers who are learning to walk. While many outgrow it naturally, some require specialized care. Currently, two primary treatment options exist when toe-walking is due to muscle tightness: casting and surgery. For casting, the patient will typically undergo a series of stretching and casting treatments, gradually increasing their range of motion. It requires a longer commitment. Surgery addresses the calf muscle length in one procedure, but can be more involved than casting. The study aims to determine which approach leads to the most significant improvements in mobility and function.

Ted Sousa M.D., a fellowship-trained pediatric orthopedic surgeon, is the medical director of the motion analysis center at Shriners Children’s Spokane.

“There are a lot of questions with regards to toe walkers,” said Dr. Sousa. “We [physicians] all have our own preferred treatment protocol because that is how it has always been done, not necessarily because that is what research tells us what is the best method.”

How the Study Works

Patients who meet the strict criteria will participate in three comprehensive studies at our state-of-the-art motion analysis centers. A team of researchers will utilize a range of cutting-edge techniques in addition to motion analysis testing, including the use of wearable foot pressure sensors, to study the patient’s gait. Patients will perform some tasks at home. Participants will also undergo further tests and imaging, as specialists explore potential genetic links.