Case 17: CMT Flashcards
prognosis for complete resolution of CMT is excellent for infants receiving intervention prior to ____ age
3 months of age
When should an infant with CMT be referred to a specialist?
-when condition remains same after 4-6 weeks intense treatment
-6 months of treatment with moderate results
-infant is older than 12 months
-infant has 10-15 degree restriction ROM
-infant is 7 months or older with SCM mass
What is Grade B evidence as the most common and effective intervention for CMT?
PASSIVE MANUAL STRETCHING
using KT tape and TOT collar are effective supplemental treatment approaches when conservative treatment is not effective: Grade __ evidence
Grade C evidence (still used as expert opinion/case series/usual practice)
resolution of CMT is achieved when infant has ____. (DISCHARGE)
- full PROM within 5 degrees of other side
- midline head/trunk
- symmetrical AROM of all body
- achieved age-appropriate motor skills
- parents have good understanding of what to monitor to prevent it coming back
Which of the following is NOT typically associated with CMT?
A. DDH
B. SCM fibrosis
C. abnormal muscle tone
D. plagiocephaly
C. abnormal muscle tone
A 5 month old infant with a 25 degree restriction of PROM L rotation and SCM mass is referred to PT.
CMT category is:
A. Grade 1 early mild
B. Grade 2 early moderate
C. Grade 3 early severe
D. grade 4 late mild
C. patient is under 6 months old, SCM mass present = Grade 3 early severe
Based on infant’s grade 3 and best evidence, which intervention should be included in initial treatment session?
A. PROM
B. facilitate rolling away from affected side
C. active strengthening of weak neck mm
D. prone positioning during play
A. PROM as first intervention for infants with CMT
What other health conditions may present with same findings as CMT?
other neuro, ocular, or MSK impairments (not listed in chapter)
What are red flags warranting referral to pediatrician for further testing?
What are most appropriate examination tests?
Describe PT POC based on child’s age, severity of CMT, plagiocephaly, and compliance with HEP
Define AIMS
developmental tool for 0-18 months
gross motor performance compared to NORM-REFERENCED PEERS
breech birth definition
baby feet or buttocks first when delivered
CVA (cranial vault asymmetry) is what
measurement of cranial asymmetry obtained by comparing longest and shortest diagonals from forehead to posterior skull using formula: (A-B)/A
A = longest diagonal
B = shortest diagonal
craniosynostosis
premature closure of cranial sutures, requires immediate referral to peds neurosurgeon
What is developmental delay?
delay in developmental milestones of fine and gross motor, language, cognition, and/or social interaction
what is DDH?
developmental dysplasia of hip
abnormal development of hip joint resulting in sublux or dislocation of femoral head in acetabulum
What is the muscle function scale?
6 point scale used to measure lateral cervical flexion strength in infants age 2 months or older
What is plagiocephaly?
deformity of skull resulting from positioning that is present at birth or develops during first few months of life
What is a TOT collar?
tubular orthosis for torticollis
*prefabricated neck orthosis, custom fit for each kid
*provides noxious stimulus to lateral aspect of skull to promote midline head position
signs and symptoms of CMT
PT precautions for CMT
passive stretching of cervical structures may be contraindicated with certain ortho/neuro conditions
passive stretching CAN CAUSE SNAPPING OF SCM IN 8% OF INFANTS
complications interfering with PT in kids with CMT
comorbidities: plagiocephaly, gastroesophageal reflux, developmental delay, cardio/neuro conditions affecting outcomes, parental noncompliance with PT/HEP, lack of infant cooperation and separation anxiety
risk factors for developing CMT
large baby
breech
decreased intrauterine space
primiparity
male
forceps/vacuum delivery
CMT
