Infants With Congenital Muscular Torticollis: Demographic Factors, Clinical Characteristics, and Physical Therapy Episode of Care.

PURPOSE: To describe demographic factors, baseline characteristics, and physical therapy episodes in infants with congenital muscular torticollis (CMT), examine groups based on physical therapy completion, and identify implications for clinical practice. METHODS: Retrospective data were extracted from a single-site registry of 445 infants with CMT. RESULTS: Most infants were male (57%), Caucasian (63%), and firstborn (50%), with torticollis detected by 3 months old (89%) with a left (51%), mild (72%) CMT presentation. Cervical range of motion (ROM) limitations were greatest in passive lateral flexion and active rotation. Sixty-seven percent of infants completed an episode of physical therapy, 25% completed a partial episode, and 8% did not attend visits following the initial examination. Age at examination, ROM, and muscle function differed significantly between groups. CONCLUSIONS: Physical therapists may use clinical registry data to inform practice for timing of referral, frequency of care, and clinician training to manage infants with CMT.

Our Journal Unites Us: Global Responsibilities and Possibilities for Pediatric Physical Therapy.

PURPOSE: This article was designed to describe personal and social responsibilities for strengthening the science of pediatric physical therapy and effective international research collaboration and communication. KEY POINTS: Common flaws in research design and analysis are reviewed with recommendations for developing research students' design and analytical skills. Our social responsibility to be informed by global knowledge is highlighted. Barriers to scientific collaboration and communication including international disparities in scientific development and language barriers are presented. Suggestions to reduce these barriers are outlined. The importance of free access to scientific literature in developing countries is reviewed. CONCLUSION: The journal should assume a leadership role in building a strong science of pediatric physical therapy through encouraging personal and social responsibility in research and serving as a model of international collaboration and communication. CLINICAL RELEVANCE: Treatment for children with movement disorders will be improved by stronger science, international collaboration, and communication.

Movement System Diagnosis.

BACKGROUND AND PURPOSE: This article presents the concept of movement system diagnoses (MSDxs), including an examination of the evolution of the ideas that are shaping the development of MSDxs. SUMMARY OF KEY POINTS: Ideas leading to development of the need for MSDxs are traced, and an overview of Diagnosis Dialog and points of consensus are provided. Four examples from areas of neurologic and pediatric practice where additional work is needed on movement system diagnosis are highlighted. CLINICAL PRACTICE: The development and use of MSDxs are deemed critical to the future development of practice in pediatric and neurologic physical therapy. The prediction of treatment outcomes through research is dependent on homogeneous groups of patients with similar signs and symptoms of movement system disorders. Only by investigating homogeneous groups with refined MSDxs will it be possible to carefully examine and identify interventions that are appropriate to a specific diagnosis. Further, our ability to identify disordered movements, including inactivity and over-activity that could lead across time to disabling conditions presents a strong argument for establishing movement system diagnoses that forewarn of the risk of disordered movement poses to health. Such movement system diagnoses would guide interventions that deter the development of disabling conditions rooted in disordered movement.