Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association Academy of Pediatric Physical Therapy.

Congenital muscular torticollis (CMT) is a postural condition evident shortly after birth. The 2013 CMT Clinical Practice Guideline (2013 CMT CPG) set standards for the identification, referral, and physical therapy management of infants with CMT, and its implementation resulted in improved clinical outcomes. It was updated in 2018 to reflect current evidence and 7 resources were developed to support implementation.

Three-Dimensional Instrumented Gait Analysis for Children With Cerebral Palsy: An Evidence-Based Clinical Practice Guideline.

Background: Children with cerebral palsy (CP) who walk have complex gait patterns and deviations often requiring physical therapy (PT)/medical/surgical interventions. Walking in children with CP can be assessed with 3-dimensional instrumented gait analysis (3D-IGA) providing kinematics (joint angles), kinetics (joint moments/powers), and muscle activity.

Purpose: This clinical practice guideline provides PTs, physicians, and associated clinicians involved in the care of children with CP, with 7 action statements on when and how 3D-IGA can inform clinical assessments and potential interventions.

Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline From the American Physical Therapy Association.

A clinical practice guideline on telerehabilitation was developed by an American Physical Therapy Association volunteer guideline development group consisting of international physical therapists and physiotherapists, a physician, and a consumer. The guideline was based on systematic reviews of current scientific literature, clinical information, and accepted approaches to telerehabilitation in physical therapist practice. Seven recommendations address the impact of, preparation for, and implementation of telerehabilitation in physical therapist practice.

Evidence-Based Practice Doctor of Physical Therapy Curricular Guideline Utilization: A Convergent Parallel Mixed Methods Study.

Introduction: In 2014, an expert panel from the American Physical Therapy Association Academy of Research Evidence-Based Practice (EBP) special interest group created the Doctor of Physical Therapy (DPT) EBP Curricular Guideline (EBP-CG). This study describes faculty awareness of the EBP-CG, DPT curricular alignment with its terminal objectives, EBP-CG uses, and challenges addressing the objectives.

Review Of Literature: DPT educators frequently use core curriculum guidelines (CGs) that articulate entry-level knowledge and skills to determine competencies.

Bridging Motor Learning Principles with Physiotherapy Specific Scoliosis Exercises: a Perspective Article.

Aim: This perspective paper illustrates the usefulness of explicitly integrating motor learning terminology with evolving therapeutic approaches. Physiotherapy specific scoliosis exercises (PSSEs) include a growing number of approaches to scoliosis management and serve as an example of this integration.

Methods: Three quintessential patient cases (a young hypermobile adolescent, a post-pubescent teen, and an adult with childhood diagnosis of scoliosis) serve to contrast the clinical decision-making process for a PSSE plan of care when organized within a motor learning framework.

Experiences of Parents of Infants Diagnosed With Mild or Severe Grades of Congenital Muscular Torticollis.

Purpose: The primary purpose of this study was to describe the experiences of parents of infants diagnosed with congenital muscular torticollis (CMT). A secondary purpose was to compare the experiences of parents of infants with mild grades versus severe grades of involvement based on the CMT severity classification system.

Methods: Through semistructured interviews, a qualitative phenomenological approach of inquiry was used to investigate the lived experiences of 12 parents.

Physical Therapy Management of Children With Developmental Coordination Disorder: An Evidence-Based Clinical Practice Guideline From the Academy of Pediatric Physical Therapy of the American Physical Therapy Association.

Background: Developmental coordination disorder (DCD), classified as a neurodevelopmental disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), affects approximately 5% to 6% of school-aged children. Characteristics of DCD include poor motor coordination and delayed development of motor skills, not explained by other conditions. Motor deficits negatively affect school productivity, performance in activities of daily living, and recreation participation.

Associations Between Congenital Muscular Torticollis Severity and Physical Therapy Episode.

Purpose: To determine how physical therapy utilization varies with Congenital Muscular Torticollis (CMT) Severity Grading Scale, considering episode of care and clinical practice guidelines.

Methods: A 3-year retrospective medical record review was conducted. Data were collected for 81 infants receiving physical therapy for CMT.

Are priorities of younger patients with knee pain addressed by PROMs? A qualitative study.

Objectives: To describe the impact of knee pain and dysfunction in young adults and determine whether current patient reported outcome measures (PROMs) address their recovery priorities.

Design: Qualitative.

Setting: Outpatient rehabilitation center.

Pediatric Physical Therapists' Use of the Congenital Muscular Torticollis Clinical Practice Guidelines: A Qualitative Implementation Study.

Purpose: This study is a follow-up to the quantitative survey to examine the perceptions of pediatric physical therapists (PTs) on the application of the 2013 Congenital Muscular Torticollis Clinical Practice Guideline (CMT CPG).

Method: Qualitative semi-structured telephone interviews were completed. Interview questions focused on how the guidelines influenced practice, facilitators and barriers to implementation, and knowledge translation activities.

Congenital Muscular Torticollis: Bridging the Gap Between Research and Clinical Practice.

Congenital muscular torticollis (CMT) is a common postural deformity evident shortly after birth, typically characterized by ipsilateral cervical lateral flexion and contralateral cervical rotation due to unilateral shortening of the sternocleidomastoid muscle. New evidence is emerging on the pathogenesis of CMT, the negative long-term consequences of delaying intervention, and the importance of early identification and early intervention to maximize outcomes. Our purpose in this article is to inform pediatricians and health care providers about new research evidence and share selected recommendations and implementation strategies specifically relevant to pediatric practice to optimize outcomes and health services for infants with CMT.

Frequency-Specific Microcurrent for Treatment of Longstanding Congenital Muscular Torticollis.

Purpose: This case describes the first episode of care, using conservative treatment, massage, and frequency-specific microcurrent (FSM), for a 19-month-old boy with grade 8 left congenital muscular torticollis with fibrotic nodules.

Methods: Ten weeks of physical therapy provided stretching, strengthening, massage, and parent education, adding FSM in weeks 3 to 10 for this patient.

Results: Full passive cervical rotation and lateral flexion, 4/5 lateral cervical flexion strength, improved head tilt, and inability to palpate fibrotic nodules were achieved by week 8, with partial home program adherence.

A Framework and Resources for Shared Decision Making: Opportunities for Improved Physical Therapy Outcomes.

Shared decision making (SDM) is a collaborative approach between clinicians and patients, where the best available evidence is integrated with patients' values and preferences for managing their health problems. Shared decision making may enhance patient-centered care and increase patients' satisfaction, engagement, adherence, and ability to self-manage their conditions. Despite its potential benefits, SDM is underutilized by physical therapists, and frequent mismatches between patients' and therapists' rehabilitation goals have been reported.

Physical Therapy Management of Congenital Muscular Torticollis: A 2018 Evidence-Based Clinical Practice Guideline From the APTA Academy of Pediatric Physical Therapy.

Background: Congenital muscular torticollis (CMT) is a postural deformity evident shortly after birth, typically characterized by lateral flexion/side bending of the head to one side and cervical rotation/head turning to the opposite side due to unilateral shortening of the sternocleidomastoid muscle; it may be accompanied by other neurological or musculoskeletal conditions. Infants with CMT should be referred to physical therapists to treat these postural asymmetries as soon as they are identified.

Purpose: This update of the 2013 CMT clinical practice guideline (CPG) informs clinicians and families as to whom to monitor, treat, and/or refer and when and what to treat.

A Core Set of Outcome Measures for Adults With Neurologic Conditions Undergoing Rehabilitation: A CLINICAL PRACTICE GUIDELINE.

Background: Use of outcome measures (OMs) in adult neurologic physical therapy is essential for monitoring changes in a patient's status over time, quantifying observations and patient-reported function, enhancing communication, and increasing the efficiency of patient care. OMs also provide a mechanism to compare patient and organizational outcomes, examine intervention effectiveness, and generate new knowledge. This clinical practice guideline (CPG) examined the literature related to OMs of balance, gait, transfers, and patient-stated goals to identify a core set of OMs for use across adults with neurologic conditions and practice settings.

Interrater and Intrarater Reliability of the Congenital Muscular Torticollis Severity Classification System.

Purpose: To establish inter- and intrarater reliability for determining severity grades of the congenital muscular torticollis severity classification system (CMT-SCS).

Methods: A prospective reliability study with 145 physical therapists recorded severity ratings on 24 randomly-ordered patient cases including age of infant, cervical range of motion, and presence or absence of sternocleidomastoid mass. To compute intrarater reliability, cases were randomly reordered and graded by 82 of the original raters.

Thirty-Second Walk Test: Expansion of Normative Data.

Purpose: To collect 30-second walk test (30sWT) normative data on a large, diverse sample of school children developing typically, ages 5 to 13 years, and describe the influences of gender, body mass index, and path shape on distance walked.

Methods: Five physical therapists administered the 30sWT on 1223 children developing typically (boys = 517, girls = 706) from 20 urban schools.

Results: Average distances (standard deviation) ranged from 139.

Uptake of the Congenital Muscular Torticollis Clinical Practice Guideline Into Pediatric Practice.

Purpose: This study describes survey responses about implementation of the congenital muscular torticollis clinical practice guideline (CMT-CPG) by pediatric physical therapists (PT) and successes and challenges with knowledge-brokering activities.

Methods: An online survey was distributed to pediatric PTs who self-identified with practice experience with congenital muscular torticollis. Data were analyzed for implementation frequency of guideline recommendations and differences pre and postpublication of the CMT-CPG.

Comparison of Teaching Strategies for Cultural Humility in Physical Therapy.

Unlabelled: Cultural competence and cultural humility are ongoing processes that healthcare professionals should continually strive for in order to provide effective and comprehensive plans of care for patients.

Methods: This 2-year, longitudinal, educational pilot study describes the levels of competency in second-year entry-level physical therapy students and compares the outcomes of three teaching strategies for cultural competence and cultural humility. All students received a standard 2-hour lecture; study volunteers were randomly assigned to one of two enriched educational groups, involving a standardized patient or a paper case enrichment.

Timed Floor to Stand-Natural: Reference Data for School Age Children.

Purpose: To collect reference data for the Timed Floor to Stand-Natural (TFTS-N) on a large, diverse sample of school children who are typically developing, taking into account age, sex, and body mass index (BMI).

Methods: Five physical therapists administered the TFTS-N on a sample of convenience of 1476 school children who were typically developing, aged 5 to 14 years (male = 637, female = 839), using previously tested, standardized reliable procedures.

Results: The average time ranged from 7.

Timed Up and Go: Reference Data for Children Who Are School Age.

Purpose: To collect normative data for the Timed Up and Go (TUG) on a large, diverse sample of urban school children who are typically developing, accounting for age, sex, and body mass index.

Methods: Physical therapists administered the TUG with natural walking speeds on 1481 children (M = 635, F = 846), ages 5 to 13 years representing 29.60% whites, 24.

Aligning Documentation With Congenital Muscular Torticollis Clinical Practice Guidelines: Administrative Case Report.

Background And Purpose: A hospital-based pediatric outpatient center, wanting to weave evidence into practice, initiated an update of knowledge, skills, and documentation patterns with its staff physical therapists and occupational therapists who treat people with congenital muscular torticollis (CMT). This case report describes 2 cycles of implementation: (1) the facilitators and barriers to implementation and (2) selected quality improvement outcomes aligned with published clinical practice guidelines (CPGs).

Case Description: The Pediatric Therapy Services of St Joseph's Regional Medical Center in New Jersey has 4 full-time, 1 part-time, and 3 per diem staff.

Two Seating Systems' Effects on an Adolescent With Cerebral Palsy and Severe Scoliosis.

Background And Purpose: To compare physiological functioning, communication switch activation, and response accuracy in a 19-year-old young man with quadriplegic cerebral palsy and neurological scoliosis using 2 seating systems within the school setting.

Methods: Prospective single-subject alternating treatment design with 2 conditions: baseline phase with standard planar inserts (A1), custom-molded back with original seat (B), and return to baseline (A2). Measures included oxygen saturation (SaO2), heart rate (HR), respiration rate (RR), body temperature (BT), processing time to activate switches, and response accuracy.

Reliability and validity of the Timed Floor To Stand Test-Natural in school-aged children.

Purpose: To establish reliability for the Timed Floor to Stand-Natural (TFTS-N) test as a stand-alone measure for schoolchildren with typical development (TD) in preparation for normative data collection.

Methods: Five physical therapists working in schools standardized testing procedures for a "natural" pace version of the TFTS. Time data were collected using a repeated-measures design.