Review Question - QID 8502

A 3-year-old girl was evaluated for toe walking. Her history was remarkable for prematurity with known intracranial hemorrhage. Her recent neurologic workup included a brain MRI scan showing periventricular leukomalacia. She walked at age 2. Gait examination revealed a crouched gait on tiptoes with knees and hips flexed. Passive range-of-motion testing revealed hip flexion contracture of 5 degrees, hamstring contracture of 15 degrees on popliteal angle testing, and ankles dorsiflex to neutral in knee extension and 15 degrees above neutral in knee flexion. Initial treatment should consist of