Exploration of physiotherapists' use of motor control strategies for the treatment of idiopathic toe walking in children: a qualitative study

Abstract

Objectives: To explore how motor control interventions are conceptualised during treatment of children with idiopathic toe walking (ITW) by physiotherapists in Australia and USA.

Design: A thematic content framework qualitative design was used to triangular the theories underpinning motor control interventions and participant responses.

Participants: Ten paediatric physiotherapists were recruited from Australia and USA. Participation was only open to physiotherapists who provided treatment to children with ITW.

Results: Physiotherapists defined the motor control interventions used for children with ITW as having the following non-hierarchical key elements: use of repetition; task scaffolding; encouraging error recognition; and, active and/or passive movements. Physiotherapists also described two superordinate themes; (1) We see motor control through the lens of how we view management and (2) Idiopathic toe walking treatment is a game with rules that are made to be broken.

Conclusions: Treatment of ITW continues to challenge clinicians. Physiotherapists viewed their approach to ITW management being evidence- informed, underpinned by motor learning theories, movement strategies and organisational treatment frameworks or guidelines to fit their individual childrens' needs. Future research should investigate if this approach affords more favourable outcomes for children with ITW gait.

Keywords: Community child health; Foot & ankle; Musculoskeletal disorders; Neuromuscular disease; Paediatric neurology; Paediatric orthopaedics.