Rosemary Peng – Treating Torticollis: Looking Beyond the Neck for Better Results

Outline

TORTICOLLIS AND POSITIONAL SKULL DEFORMITIES – WHEN TO TREAT OR REFER

• Three types: Brachycephaly, plagiocephaly, scaphocephaly
• Craniosynostosis
• When and how to treat it
• When is it time for consultation with neurosurgery

HOW TO PROPERLY ASSESS A CHILD WITH CMT

• Posture
• Cervical range of motion: active and passive
• Muscle function scale for Infants
• Thoracic and lumbar spine
• Muscle flexibility of extremities
• Screen for developmental hip dysplasia
• Skin, facial, and skull asymmetries
• Visual motor skills: tracking, presence of nystagmus, midline control
• Classification of level of severity

EXAM LAB

HOW TO BEST TREAT CMT – LOOKING BEYOND THE NECK

• Cervical PROM
• Addressing other asymmetries below the neck
• Positioning
• Incorporate play into treatment
• Strengthening
• Addressing vision
• Why and how we address fine and gross motor skills
• Tummy time challenges
• Adapting the environment
• Caregiver education

INTERVENTION LAB

OTHER THERAPEUTIC APPROACHES FOR CMT

• Microcurrent
• Myokinetic stretching
• Kinesiological taping
• TAMO approach
• TOT and other collars
• Botox
• Surgery

EMERGING INTERVENTIONS WITHOUT EVIDENCE OF EFFICACY

• Manual therapy/cervical manipulation
• Craniosacral therapy
• Soft tissue massage
• Feldenkrais
• Total Motion Release

WHEN TO REFER FOR CONSULTATION

• 7 Red flags that indicate the need for referral to MDs

HOW TO IMPROVE YOUR GOAL WRITING

• Symmetrical movement
• Motor development
• Parent/caregiver understanding

DISCHARGE PLANNING AND FOLLOW-UP RECOMMENDATIONS

• Criteria for discharge
• Parent/caregiver understanding
• Follow-up screening recommendations

CASE EXAMPLES