Case 17- Congenital Muscular Torticollis ( CMT)

Question 1

Alberta Infant Motor Scale (AIMS)

Answer 1

Developmental tool appropriate for infants from birth through independent walking ( 0-18 months) used to identify gross motor performance of infants compared to norm-reference peers

Question 2

Breech Birth

Answer 2

Presentation of the fetus with buttocks or feet first prior to delivery

Question 3

Cranial Vault Asymmetry (CVA)

Answer 3

Measuremnt of cranial asymmetry obtained by comparing the longest and shortest diagonlas from the forehead to te posterior skull using formula (A-B)/A, where A is the longest diagonal and B is the shortest diagonal

Question 4

Craniosynostosis

Answer 4

Premature closing of cranial structure; requires immediate referral to a pediatric neurosurgeon

Question 5

Developmental Delay

Answer 5

delay in the developmental milestones of fine and gross motor, language, cognition, and/or social interaction

Question 6

Developmental dysplasia of the hip

Answer 6

abnormal development or growth of the hip joint that result in subluxation or dislocation of the femoral head in the acetabulum of the pelvis

Question 7

Muscle function scale

Answer 7

6 point scale used to measure lateral cervical flexion strength in infants aged 2 months or older

Question 8

Plagiocephaly

Answer 8

Deformity of the skull resulting from positioning that is present at birth or develops during the first few months of life

Question 9

Tubular orthosis for torticollis( tot collar)

Answer 9

Prefabricated neck orthosis that is custom fit to each child, it is designed to provide a noxious stimulus to the lateral aspect of the skull to promote midline head position

Question 10

The prognosis for complete resolution of CMT is excellent for infants who receive intervention prior to 3 months of age

Answer 10

Grade A

Question 11

Passive manual stretching is the most common and effective intervention for CMT

Answer 11

Grade B

Question 12

The use of kinesiological tape and TOT collar are effective supplemental treatment approaches when conservative treatment is not effective

Answer 12

Grade C

Question 13

Which of the following is NOT typically associated with CMT

Answer 13

Abnormal muscle tone; this may be a red flag for a neurological impairment

Question 14

A five-month-old infant with a 25-degree restriction of passive cervical rotation to the left and an SCM mass is referred to PT for treatment of CMT. This patient would be categorized as

Answer 14

Grade 3: Early severe

Question 15

Based on the Infants CMT severity grade and best evidence, which intervention should be included in the initial treatment

Answer 15

Cervical PROM; literature supports that passive ROM is the first intervention for infants diagnosed with CMT

Question 16

Grade 1

Answer 16

Early mild; Infant in first 3 months of life with only postural or muscle tightness <15 degree

Question 17

Grade 2

Answer 17

Early moderate; infant between 4 and 6 months of age with muscle tightness 15-30 degree

Question 18

Grade 3

Answer 18

Early severe; infant between age 4 and 6 months of age with muscle tightness of > 30 degree OR SCM mass

Question 19

Grade 4

Answer 19

Late Mild; infant between 7 and 9 months of age with only postural or muscle tightness < 15 degree

Question 20

Grade 5

Answer 20

Late moderate; Infant between 10 and 12 months of age with only postural or muscle tightness of < degree

Question 21

Grade 6

Answer 21

Late sever; Infant between 7 and 12 months of age wth muscle tightness> 15 degree

Question 22

Grade 7

Answer 22

Late Extreme; infant after 7 months of age with SCM mass OR after 12 months of age with muscle tightness of > 30 degree, presence of SCM mass OR referred after 12 months of age