| Summary: | Importance: The cause of idiopathic toe walking (ITW) remains unclear, though impaired sensory processing has often been hypothesized to be linked to ITW. Objectives: The objective of this article is to review the literature on toe-walking to identify how sensory processing contributes to ITW. Data Sources: Four databases (CINAHL, Pubmed, PsychINFO, and SCOPUS) were searched for papers related to sensory processing and ITW published prior to July 2024. References of retrieved papers were reviewed for additional sources. Study Selection and Data Collection: The PRISMA guidelines for scoping review were used to abstract the data following Joanna Briggs Institute methodology. Inclusion criteria were examined and papers included at least one sensory system related to ITW was studied. Papers were excluded if toe walking was due to diagnosed neurological, orthopedic, or genetic conditions. Findings: Our scoping review identified 13 published articles relevant to examining sensory processing in children with ITW. Studies explored differences in vibration perception, light touch, proprioception, vestibular, visual processing, sensorimotor functional assessments, and parental surveys of sensory processing. Six of the papers were included in a meta-analysis on vibration perception threshold that failed to reach significance (p =.12). Despite heterogeneity across studies in participants, methods, and outcomes, a meta-analysis for atypical scores from parent-report sensory processing survey data yielded significant differences between children with ITW and typical controls (p <.0068). Conclusions and Relevance: Children with ITW demonstrate impairments across multiple domains of sensory processing and sensory-motor function suggesting an underlying relationship between ITW and sensory differences. Children with ITW, however, represent a diverse group of individuals with significant between-subjects variability in which senses are impaired, and which outcome measures best capture these differences. Plain Language Summary: This review was undertaken to examine the role sensory processing differences play in idiopathic toe walking (ITW). ITW is defined as consistent walking on toes (without heel strike) that is not due to other medical conditions. The results of this review showed that atypical responses to sensory stimuli are frequently reported in children with ITW. These differences were observed across multiple domains of sensory processing. However, the differences in sensory processing in children with ITW varied greatly among individuals in terms of which senses showed impaired processing. Furthermore, children with ITW often have reduced range of motion in their ankles, reduced strength, and difficulty with balance. Sensory-based interventions show potential for modifying walking patterns in children with ITW.
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