Evidence-Based Examination and Treatment of Congenital Muscular Torticollis

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Handouts/Brochure

Speaker

Rosemary Gambatese, PT, MSPT Related seminars and products

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Rosemary Gambatese, PT, MSPT, is a physical therapist with 38 years’ clinical experience. She received a BS in Biology from St. Bonaventure University and MS in PT from Arcadia University. She is an advanced clinical specialist at Kessler Rehabilitation Center in Flanders, NJ with specialties in pediatrics and neurology. In addition to her work at Kessler, she has been an adjunct instructor at Rutgers University School of Health-Related Professions, Department of Physical Therapy, a consultant for early intervention and a contract therapist for agencies providing physical therapy in school settings. Practicing for over 30 years, Rose brings a wide range of experience and clinical expertise to her specialty areas of pediatrics and neurology. She has presented seminars for PESI, APTANJ and Select Medical Corporation on topics including congenital muscular torticollis, school-based PT intervention, cerebral palsy, and intervention to overcome sedentary behavior at all ages. Rose has presented a poster at APTA Combined Section Meeting on a novel stroke treatment an co-written articles on vestibular, stroke, and therapeutic exercise topics.

Speaker Disclosures:
Financial: Rosemary Gambatese has employment relationships with Rutgers University and Kessler Institute for Rehabilitation, Inc. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Rosemary Gambatese is a member of the American Physical Therapy Association and the New Jersey Chapter of the American Physical Therapy Association.

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Objectives

1. Assess types and causes of infant torticollis and commonly associated skull deformities.
2. Employ evidenced-based examination and intervention strategies for infants with CMT.
3. Differentiate red flags that may warrant referral to a physician.
4. Determine prognosis based on clinical findings.
5. Examine intervention approaches that have not yet established efficacy.
6. Integrate evidenced-based discharge planning, caregiver education and recommendations for follow-up care.

Outline

• Three types: Brachycephaly, plagiocephaly, scaphocephaly
• Craniosynostosis
• When and how to treat it
• When is it time for consultation with neurosurgery

• Posture
• Cervical range of motion: active and passive
• Muscle function scale for Infants
• Thoracic and lumbar spine
• Muscle flexibility of extremities
• Screen for developmental hip dysplasia
• Skin, facial, and skull asymmetries
• Visual motor skills: tracking, presence of nystagmus, midline control
• Classification of level of severity

• Cervical PROM
• Addressing other asymmetries below the neck
• Positioning
• Incorporate play into treatment
• Strengthening
• Addressing vision
• Why and how we address fine and gross motor skills
• Tummy time challenges
• Adapting the environment
• Caregiver education

• Microcurrent
• Myokinetic stretching
• Kinesiological taping
• TAMO approach
• TOT and other collars
• Botox
• Surgery

• Manual therapy/cervical manipulation
• Craniosacral therapy
• Soft tissue massage
• Feldenkrais
• Total Motion Release

• 7 Red flags that indicate the need for referral to MDs

• Symmetrical movement
• Motor development
• Parent/caregiver understanding

Discharge Planning and Follow-up Recommendations

• Criteria for discharge
• Parent/caregiver understanding
• Follow-up screening recommendations

Case Examples

Target Audience

• Physical Therapists
• Physical Therapy Assistants
• Occupational Therapists
• Occupational Therapy Assistants
• Chiropractors
• Rehab Nurses
• Other Healthcare and Rehabilitation Professionals