Commentary on “Pediatric Physical Therapists' Use of the Congenital Muscular Torticollis Clinical Practice Guidelines: A Qualitative Implementation Study”

Abstract

“How could I apply this information?” A majority of the 13 therapists participating in the study had a positive view of the 2013 congenital muscular torticollis (CMT) clinical practice guideline (CPG)1 and were able to implement the CPG in a variety of settings. The CPG1 had an effect on the participants' CMT-related examination and discharge practices and a lesser effect on participants' intervention practices. Identifying aspects of the 2013 CMT CPG,1 which participants found to be helpful (eg, the CMT classification grades and decision tree) and frustrating (ie, the perception that the CPG1 should include certain interventions), provides insights into educational needs regarding use of CPGs that may help therapists to integrate CPGs into their practice. “What should I be mindful about when applying this information?” Although this study was well designed, having more than 1 researcher involved in conducting the interviews and conducting the interviews in a face-to-face format (either in-person or through video conferencing) would have reduced the risk for bias. As indicated in the article discussion, the degree and consistency to which participating therapists used and applied the 2013 CMT CPG1 may not be representative of all pediatric therapists who work with children who have CMT. Additional research involving participants with varying levels of experience or inexperience with the CMT CPG1,2 would capture a broader range of opinions and may help to identify pertinent factors related to why some therapists use the CMT CPG1,2 while others do not. Future research exploring therapists' perceptions related to use of the updated 2018 CMT CPG2 and related online Implementation Resources3 also would be beneficial. Lisa K. Kenyon, PT, DPT, PhD, PCS Department of Physical Therapy, Grand Valley State University Grand Rapids, Michigan Micah Huegel, PT, DPT Mary Free Bed Rehabilitation Hospital Grand Rapids, Michigan