LAUSR

“How should I apply this information?” This study highlights the discrepancies in care of infants with congenital muscular torticollis (CMT) and the use of clinical practice guidelines (CPGs). Many pediatric physical therapy clinics have developed treatment protocols for infants with CMT, which may or may not be based on the CPG. Evaluating our protocols to ensure that they include all elements of this CPG improves the quality of care we provide. Three simple strategies that respondents reported can easily be established in our clinics, if they are not already present. These include a standardized documentation form, continuing education courses on how to perform specific tests/measures, and a parent-friendly brochure that explains the recommended actions. The Academy of Pediatric Physical Therapy (APPT) resources in development should serve to enhance the integration of the CPG into everyday practice. “What should I be mindful about when applying this information?” The majority of respondents had extensive clinical experience and were professionally involved in the APPT. The outcomes may be different if nonmember clinicians and/or those with less experience are better represented. Knowledge brokering activities to target these clinicians should be addressed. The results reinforce that therapists must increase efforts to educate local physicians on the importance of both screening and long-term follow-up. Although implementation of recommendations improved after publication of the CPG, a portion of respondents still reported using several recommendations “never” or “rarely.” Future research should explore clinicians’ reasoning for not implementing certain recommendations, for example, lack of rigorous research, time, or confidence in skills. One specific recommendation, classification of the level of severity, continued to be implemented by only 57% of respondents. This recommendation is based on expert opinion and lacks psychometric evidence; therefore, further research will be beneficial and likely increase the percentage of clinicians who use classification.