Sensorimotor integration plus targeted stretching for toe walking in children with autism

Combined Effects of Sensorimotor Integration and Post-facilitation Stretch on Toe Walking and Foot Posture in Children With Autism Spectrum Disorder

This study tests whether sensorimotor integration exercises combined with post‑facilitation stretching can reduce toe walking and improve sensory processing in children with mild autism.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 36 (estimated)
• Ages: 4 Years to 10 Years
• Sex: All
• Sponsor: Riphah International University (Academic / other)
• Locations: 1 site (Islamabad, Punjab Province)
• Trial ID: NCT07484347 on ClinicalTrials.gov

What this trial studies

Children with mild autism who primarily toe walk due to Achilles tightness will receive either a combination of sensorimotor integration therapy and post‑facilitation stretching or post‑facilitation stretching alone. Outcomes will include changes in foot posture measured by the Foot Posture Index and sensory behaviors measured by the Sensory Profile, along with gait observation of toe‑walking frequency. The interventions are delivered in person at the clinical site and require participants to be able to follow simple commands and complete gross motor tasks. The trial excludes children whose toe walking is explained by neurological or orthopedic conditions or who have had prior lower limb surgery.

Who should consider this trial

Good fit: Ideal candidates are children with diagnosed mild autism who toe walk on more than half of steps due exclusively to Achilles tightness and who can follow simple verbal commands and perform gross motor tasks.

Not a fit: Children whose toe walking is caused by neurological or orthopedic disorders, prior Achilles or lower limb surgery, involvement in other gait therapies, or severe behavioral/sensory issues that prevent participation are unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, the combined approach could reduce toe walking and improve sensory processing, leading to better mobility and day‑to‑day function for affected children.

How similar studies have performed: Physical stretching and sensorimotor approaches have been used separately for idiopathic toe walking and sensory problems, but combining sensorimotor integration with post‑facilitation stretch specifically for autistic toe walking is largely untested.

Eligibility criteria

Inclusion Criteria:

* Children with diagnosed Mild Autism Spectrum Disorder
* Presenting with toe walk as a prominent feature of Autism Spectrum Disorder (e.g., more than 50% of steps observed during a gait assessment). Toe walking should be entirely because of Achilles tightness.
* Able to follow simple verbal commands.
* Sufficient gross motor skills present.

Exclusion Criteria:

* Toe walking due to neurological (e.g., cerebral palsy, spina bifida, peripheral neuropathy) or orthopedic disorders (e.g., clubfoot, leg length discrepancy \> 1 cm, hip dysplasia, contractures not related to idiopathic toe walking) and other behavioral factors that could be the primary cause of toe walking will be excluded.
* History of Achilles tendon surgery or lower limb surgery.
* Current participation in another physical therapy intervention targeting gait or posture
* Severe behavioral/sensory issues that would interfere with treatment sessions i.e. severe Autism Spectrum Disorder with Attention Deficit Hyperactivity Disorder as well as mental retardation.
* Non-ambulatory children.

Where this trial is running

Islamabad, Punjab Province

• Fauji Foundation Hospital — Islamabad, Punjab Province, Pakistan (Recruiting)

Study contacts

• Principal investigator: Maria khalid, MSOMPT — Riphah International University
• Study coordinator: maria Khalid, MSOMPT

Conditions Autism Spectrum Disorder; Autism; sensory motor integration; Post facilitation stretch