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Pediatric Physical Therapy:
doi: 10.1097/PEP.0b013e31829732b0
Clinical Bottom Line

Commentary on “Factors Affecting Parental Adherence to an Intervention Program for Congenital Torticollis”

Thillet-Bice, Florence PT, DPT, MA, PCS; Fetters, Linda PT, PhD, FAPTA

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The authors declare no conflicts of interest.

“How should I apply this information?”

Clinically, these results support the importance of parents' understanding of the potential effect of untreated torticollis on their infants' future function. Mothers who viewed torticollis as a more serious threat to their children's future functioning attended more physical therapy sessions and worked more on the exercises at home. Clear and direct explanations of the likelihood of resolution of the torticollis as a result of exercises and the effect of nonresolution of the torticollis should be emphasized during the initial physical therapy session. This research also supports the importance of providing home programs for children with torticollis regardless of whether the mother has an active or passive approach to their child's care in physical therapy. The importance of attending therapy is also supported in that the more sessions attended, the more exercises were performed at home.

“What should I be mindful about applying this information?”

The reliability and validity of several of the tools used were not established with mothers of infants with torticollis and may have affected the results, such as the relationship between adherence to the therapy and whether the mother was a passive recipient or an active participant in providing services. Parent educational background was not described, and only women who spoke the same language as the therapists were used in the study. Many children treated in the United States are of mothers who speak a different language and have a different educational background in comparison to the therapists. When the ability to communicate is affected, trust and follow through may also be affected. The various populations we serve in the United States may also have a different concept of “disease threat” based on their background and experiences. Because the perception of the effect of torticollis was important to therapy adherence, understanding this parent perception is critical to intervention adherence.

Florence Thillet-Bice, PT, DPT, MA, PCS
Reach Healthcare Services
Houston, Texas

Linda Fetters, PT, PhD, FAPTA
University of Southern California
Los Angeles, California

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.

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