11
How do we measure cervical PROM in children with torticollis?
Arthrodial protractor
What physical change can happen to the SCM that is visible or palpable if the torticollis is more serious?
SCM mass
Classify severity level:
- Late - moderate 10-12 months
- Postural, muscle tightness
- < 15 degrees cervical rotation
Muscle function scale score:
High above horizontal line
4
- Severity classification grade
- Access to services and clinician knowledge and skill
- Patient/caregiver CMT knowledge
- Muscle tissue characteristics
- Infants developmental stage
- Comorbidities
Frequency/duration
- Age of initiation of treatment
- Classification of severity
- Intensity of intervention
- Presence of comorbidities
- Rate of change
- Adherence to HEP
#12 Determine prognosis
- Supported/unsupported
- Compensations in shoulders, trunk and hip
Sitting body structure
Muscle function scale score:
Head on horizontal line (straight line with body)
1
Classify severity level:
- Muscle tightness
- 15-30 degrees of cervical rotation
- early - moderate 0-6 months
Grade II
Muscle function scale score:
High over horizontal line
3
- Asymmetry of the spine/presence of scoliosis
- Head and trunk
- Use of asymmetric patterns
- Tolerance to position
Prone body structure
Static: assess balance, head position, shoulder girdle, rib cage, pelvic girdle
Dynamic: assess the movement of infant, control of body in space, full AROM, weight bearing status, atypical patterns, movement blocks, gross motor milestones
#10 Examine activity and developmental status
Classify severity level:
- Muscle tightness
- SCM mass
- > 30 degrees of cervical rotation
- early - severe 0-6 months
Grade 3
Classify severity level:
Very late: after 12 months
- Muscle tightness
- > 30 degrees of cervical rotation
- Postural muscle tightness OR SCM mass
Proposed grade 8
Classify severity level:
- Late - severe 7-12 months
- Muscle tightness
- > 15 degrees cervical rotation
Grade 6
Classify severity level:
- Postural, muscle tightness
- < 15 degrees of cervical rotation
- Late - mild 7-9 months
Grade 4
Muscle function scale score:
Head below horizontal line
0
Classify severity level:
- Postural, muscle tightness
- < 15 degrees of passive cervical rotation
Grade I : early - mild 0-6 months
When doing the muscle function scale with a torticollis baby, they will have a higher or lower score because of contracted muscles?
What will the score look like on the opposite side?
Higher
Opposite side: have a lesser score because they cannot pull head up due to muscle tightness
T/F: Prone positioning while awake for greater than 1 cumulative hour per day, with no minimum amount of time per opportunity, appears to offset the transient effects of supine sleep positions on motor skill acquisition
True
Muscle function scale score:
Slightly over horizontal line
2
Prevention: signs before symptoms
Correction: repeated movements and sustained postures cause impairments
- Correction of muscle length
- Correction of muscle in postural positions
- Correction of muscle in functional activities
- Proper proprioception integral motor regulation
#11 Examine participation status
Classify severity level:
- Late extreme after 7 months
- SCM mass
- > 30 degrees of cervical rotation
Grade 7
1. Environmental adaptations: crib position, caregiver position, changing table position
2. Parent/caregiver education: print out, hands on demonstration, teach back method
3. Neck PROM: myofascial work, calm tissue elongation, manual soft tissue work
4. Neck and trunk AROM: prone play, supported sitting, isolated chin tucks
5. Development of symmetric movement: use a mirror, concentrate on midline positions
#13 Five components of first choice interventions
Muscle function scale score:
Very high above horizontal line almost vertical position
5