The purpose of this study is to determine whether botulinum toxin A (BTX) adds a favourable
effect to treatment of idiopathic toe-walking with below knee walking casts. The specific
hypothesis to be tested is that a combination of BTX and casting is more effective than
casting treatment alone in reducing toe-walking in 5-15 year old children. Evaluation methods
include 3-D gait analysis, parents' perception of toe-walking frequency, passive joint range
of motion measurements, and strength of ankle dorsal extension.