Heather Weesner Therapy for Developmental muscular torticollis (DMT) . Definition of DMT . Etiology a. Fetal malposition b. Uterine compression c. Birth Trauma d. Ischemic event e. Infection . Common characteristic features of DMT a. Frontal flattening b. Flattened contralateral ear c. Flattened jaw line d. Tilted mandible e. Elevated ear . Differential Diagnosis a. Cervical vertebrae subluxation b. Posterior fossa tumor c. Spinal abnormalities d. Ocular problems . . Evaluation a. History i. Pregnancy, labor or delivery complications ii. Birth weight, length, gestational age iii. Medical complications since birth iv. Familial history of torticollis v. Sleep Position vi. Changes in symptoms over time b. Screening i. Neurological ii. Hip iii. Vision iv. Pain c. Physical Examination i. Assess for resting head positions, active and passive cervical rotation, lateral flexion, lateral head righting, neck flexor strength, hip status, facial asymmetry, palpation of the SCM ii. Development and age-appropriate gross and fine motor skills Treatment a. Initial visit i. Patient education on HEP geared towards; elongating tightened muscles, creating symmetry in car seats and sleeping, and strengthening weak motions with tracking/righting techniques ii. Educating patients on diagnosis and pathology of DMT b. Second visit/follow-up visits i. Review/parent demonstration of HEP ii. Update HEP with different developmentally appropriate activities iii. Reassessment of cervical ROM, posture, positioning, skull/facial . . . . iii. Reassessment of cervical ROM, posture, positioning, skull/facial shape iv. Screen of trunk, UE/LE ROM Intervention Tools a. Cervical positioning devices 1. Soft foam collar 2. TOT collar 3. Benik ii. Kinesio Taping Possible complications of conservative treatment a. SCM spasm b. Rupture of the muscle c. Fracture of clavicle Outcomes/Prognosis Discharge Criteria
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