Assessment & Research

Abnormal Foot Position and Standing and Walking Ability in Rett Syndrome: an Exploratory Study.

Borst et al. (2018) · Journal of developmental and physical disabilities 2018
★ The Verdict

Uneven foot pressure predicts walking trouble in Rett—check weight shift before fitting orthotics.

✓ Read this if BCBAs writing gait goals for girls with Rett in clinic or school.
✗ Skip if Practitioners who only serve verbal adults with no motor plan.

01Research in Context

01

What this study did

The team asked 42 girls and women with Rett syndrome to stand on a pressure mat.

They measured how much weight each foot took and watched who could stand or walk alone.

A quick survey told the researchers who used walkers, braces, or only sat.

02

What they found

People who put more weight on one foot were far less likely to walk by themselves.

Heavy pressure on the toes and little on the heels also predicted poor standing balance.

In short, uneven feet meant weaker walking skills.

03

How this fits with other research

Curran et al. (2025) saw tiny motor slips in baby twins years before Rett regression.

E’s team now shows those early slips may snowball into lopsided foot loading later.

Deserno et al. (2017) found similar left-right gaps in older kids with DCD, proving asymmetry is not unique to Rett.

Osório et al. (2025) added that autistic toddlers vary step to step; E shows the Rett group freeze one pattern, making the problem easier to spot on a mat.

04

Why it matters

Before you order ankle braces or shoe inserts, place a $40 pressure mat on the floor.

A 30-second stand gives you a picture of weight shift and helps pick the right support.

Spotting bad foot balance early could keep your client walking longer and safer.

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→ Action — try this Monday

Tape two bathroom scales to the floor and have your client stand still for ten seconds—note the weight split.

02At a glance

Intervention
not applicable
Design
survey
Sample size
67
Population
other
Finding
negative

03Original abstract

This study aimed to determine whether there is a relationship between abnormal foot position and standing and walking ability in individuals with Rett syndrome (RTT), a rare neurological condition primarily affecting females, often accompanied by impaired gross motor function and musculoskeletal deformities. Through means of an online survey, physiotherapists were asked to share information about their work and experience with individuals with RTT. They were asked about their clients' scores on the Rett Syndrome Gross Motor Scale and measures of their foot deformity, passive range of motion of dorsiflexion of the foot, use of supportive footwear, pressure load on the foot, and symmetry in weight bearing. 45 physiotherapists gave answers relating to 67 individuals with RTT who ranged in age from 2 to over 50 years. Almost 80% had an abnormal foot position which required support of special shoes or orthoses. Approximately 55% experienced abnormal pressure load on the foot and 65% demonstrated asymmetrical weight-bearing; 22% could sit independently and 17% were able to stand and walk independently. Of all the variables investigated, only abnormal distribution of pressure on the foot and asymmetry in weight bearing through the legs were found to be (negatively) correlated with standing and walking ability. Physiotherapists can use this information to give advice on othopedic support for the feet of individuals with RTT.

Journal of developmental and physical disabilities, 2018 · doi:10.1016/S0387-7604(12)80169-0