Neck dysfunction is almost a universal finding in
patients with deformational plagiocephaly. Sometimes this
dysfunction is overt, and infants are unable to turn their heads
to midline. More often, the problem is subtle, and careful
examination of the neck should be performed for any signs of
restriction in motion. When examining an infant with neck
dysfunction, it is important to evaluate both their active and
passive ranges of motion. Regardless of the final course of
treatment, chosen for abnormal head shape (repositioning,
orthotic
management,
surgery),
treatment of neck dysfunction with neck exercises is imperative.
In severe cases, surgical intervention may be indicated.
Neck Exercises
"Neck exercises should be done with each
diaper change. There are 3 repetitions per exercise, and it is
estimated to take approximately 2 additional minutes per
diaper change. One hand is placed on the child's upper chest,
and the other hand rotates the child's head gently so that the
chin touches the shoulder. This is held for approximately 10
seconds. The head is then rotated toward the opposite side and
held for the same count. This will stretch out the
sternocleidomastoid. Next, the head is tilted so that the
infant's ear touches his or her shoulder. Again, the position
is held for a count of 10 and repeated for the opposite side.
This second exercise stretches the trapezius muscle.
Additionally, the parents may be taught the rotating chair or
stool technique to enhance neck motion in the infant."
Source: Persing J, James H, Swanson J, Kattwinkel J.
Prevention and management of positional skull deformities in
infants. American Academy of Pediatrics Committee on
Practice and Ambulatory Medicine, Section on Plastic Surgery
and Section on Neurological Surgery. Pediatrics 2003 Jul;112(1
Pt 1):199-202.
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