Rosemary Peng – Treating Torticollis

My name is Rosemary Peng, PT, MST. As a clinician who has worked for more than 20 years in pediatric settings, I’ve seen and treated patients with congenital muscular torticollis (CMT).

 Rosemary Peng – Treating Torticollis

TORTICOLLIS & POSITIONAL SKUL DEFORMITIES – WHEN to TREAT OR REFER

• There are three types: Brachycephaly (plagiocephaly), scaphocephaly
• Craniosynostosis
• How to treat it and when
• When is it appropriate to consult with neurosurgery?

CMT: HOW TO PROPERLY ASSEMBLE A CHILD

• Posture
• Cervical motion range: Active and Passive
• Infants’ muscle function scale
• Thoracic and Lumbar spine
• Extreme muscle flexibility
• Screen for developmental hip dysplasia
• Asymmetries of the skin, skull, and facial
• Visual motor skills: midline control, presence of Nystagmus, tracking
• Scoring of severity

EXAM LAB

HOW TO BEST TREAT CMT- LOOKING BEYOND NECK

• Cervical PROM
• Resolving other issues below the neck
• Positioning
• Incorporate play in treatment
• Strengthening
• Addressing vision
• How and why we should address fine and gross motor skills
• Tummy time challenges
• How to adapt to the environment
• Caregiver education

INTERVENTION LAB

CMT: OTHER THEAPEUTIC APPROACHES

• Microcurrent
• Myokinetic stretching
• Kinesiological tapping
• TAMO approach
• TOT and Other Collared
• Botox
• Surgery

EMERGING INTERVENTIONS – EVIDENCE OF EFFICACY NOT AVAILABLE

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

WHERE TO GO FOR CONSULTATION

• 7 Signs to refer to MDs

HOW TO IMPROVE YOUR GROUP WRITING

• Symmetrical movement
• Motor development
• Understanding parent/caregiver

FOLLOW AND DISCHARGE PLANNING-RECOMMENDATIONS UP

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

CASE EXAMPLES

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Description:

My name is Rosemary Peng, PT, MST. As a clinician who has worked for more than 20 years in pediatric settings, I’ve seen and treated patients with congenital muscular torticollis (CMT). I used to focus too much on the neck and neglect other possible asymmetries. I saw very little improvement. Was there something I was missing? This population had to be treated in a more effective way. Finally, I found that I could treat my patients effectively by including 7 body parts in my examination. This allowed me to strengthen neck muscles, promote better head posture and improve fine and gross motor skills.

Learn and practice evidence in this recording-I use the evidence-based tools in the 2018 Clinical Practice Guidelines to accurately assess and treat infants. You’ll enhance your skills by learning proven treatment techniques as well as alternative approaches that don’t make your patient feel discomfort and results in better outcomes. With clear goals and education, parents and caregivers can lessen their anxiety. These proven strategies can be immediately applied in your clinical setting to make you feel confident and comfortable.