Sensory Integration and Praxis Characteristics in Children with Idiopathic Toe Walking: A Case–Control Study

Aims: Idiopathic toe walking (ITW) is persistent forefoot walking without identifiable neurological or orthopedic causes. Emerging evidence suggests sensory–motor contributions, yet performance-based evaluations are limited. This study aimed to compare sensory integration and praxis in children with ITW and typically developing (TD) peers. Methods: This case–control study included 60 children (4–8 years 11 months): 30 with ITW and 30 TD. Diagnosis was confirmed using the Idiopathic Toe Walking Tool–Turkish Version. Sensory integration and praxis were assessed with the Sensory Integration and Praxis Tests (SIPTs). Group differences were analyzed using univariate analyses with Bonferroni correction, and dysfunction patterns were identified. Results: Children with ITW showed significantly poorer performance on several SIPT subtests, including Manual Form Perception, Graphesthesia, Postural Praxis, Praxis on Verbal Command, Oral Praxis, Bilateral Motor Coordination, and Standing and Walking Balance (p < 0.001). Figure–Ground perception also differed (p = 0.003), while kinesthesia and postrotary nystagmus did not. Somatodyspraxia was identified in 86.7% of the ITW group; other patterns were less frequent. No TD child met dysfunction criteria. Conclusions: Children with ITW exhibit sensory integration and praxis impairments, supporting a sensory–motor basis and the need for performance-based assessment.