14 0 obj Memorial Sloan Kettering was founded in 1884, and today is a world leader in patient care, research, and educational programs. xT*S+`]wQNV foi8=.n.?Sf\i"{))oK'pP ,w$Z98C9gV:Jwi\2spApRAc+x5FA:4qkXlgCSYbkeDCJwp|IT~&Sl7=bw9H\l/)a0&lIv;VJXBLj@0z> Cervical collars may be used for a short period of immobilization during an acute phase. Miscellaneous treatment considerations post laminectomy: - Instruction on spinal precautions is indicated and should be reinforced with all activity, 1. For this reason, your doctor may prescribe occupational therapy to assist you in learning alternate methods to perform these tasks. endstream endobj 382 0 obj <>stream For those patients who are followed in our clinic but who receive therapy from their local communities, our therapists are able to consult with distant health providers about continued care and treatment strategies to maximize progress. fn Your doctor first implants the leads, then the battery (also called a pulse generator or device). What happens if cervical radiculopathy is left untreated? You cant feel your fingers unless you are looking at them which makes driving hard or even doing your buttons. When the spinal nerves have pressure put on them, they cannot properly transmit messages from the brain to the muscles. If you are at all worried about your neck pain or numbness in your hands due to cervical radiculopathy Ive written this blog with you in mind. 0000057682 00000 n But the no pain no gain mentality does not work with this type of issue. endobj This will help you keep good posture. Some resources state to wear the sling for 4-6 weeks while sleeping and while entering the community, but this will depend on the surgeons orders. And along with the prior orthopedic surgeries, hip kits are invaluable to patients following spinal surgery or injury to adhere to spinal precautions and make dressing tasks achievable. Age and arthritis of the cervical bones are often blamed for the pain. Specifically note prior use of heat for this condition -Aggravating/easing factors (and length of time each item is performed before the symptoms come on or are eased) 5.1 Respiration. Decreasing pain and joint stiffness. The general precautions immediately following shoulder arthroplasty are as follows, but may differ on an individual basis. This post includes mainly precautions with some home safety. 4l8,]f, And that is the worse case scenario. Traction may temporarily decompress nerve impingement. For 2 or more levels a hard collar is used for a period of 6 weeks. 5 Precautions and Prevention. Call your healthcare provider to tell them if this happens. you otherwise, follow the safety guidelines (precautions) in this handout. CERVICAL PRECAUTIONS: Wear your cervical collar at all times or as recommended by doctor . 0000006020 00000 n Most often, its in the clinical questions that a doctor or a skilled occupational therapist or physical therapist can ask that will rule in or rule out the diagnosis of cervical radiculopathy. Your abdomen should rise but your upper chest should stay still and relaxed. 0000007267 00000 n This stops you from shrugging. 0000000016 00000 n This is a really great summary. Position client in supine and ask to "log roll" to their side, - The brace should be washed with a mild soap and water daily endobj Patients with upper . Weight-Bearing Precautions. 4. Spinal surgeries, whether elective or not, may also be extremely painful for your patient the first few days. Reducing tightness in the surrounding muscles. Sometimes being very aggressive might feel good but then actually cause you pain later. There are several different phases that we address during your evaluation with us so that you can get lasting results. %PDF-1.6 % Talk with your healthcare provider before lifting or carrying things over 3 pounds. Spinal precautions also known as spinal immobilization and spinal motion restriction, are efforts to prevent movement of the spine in those with a risk of a spine injury. To doff the shirt, start with taking the shirt off the non-operative arm first, Use the non-surgical arm for all other basic ADLs until cleared (grooming, eating, bathing, dressing, cooking, etc. %%EOF They are usually given out after accidents or from urgent care centers. There are many variations of adaptive utensils for spinal cord injury patients with upper extremity motor impairments. - Car transfer %PDF-1.4 % 17 0 obj 0000003192 00000 n Physical Therapy / Occupational Therapy. Or want to avoid getting injections and surgery request to speak with our specialist. Sit or stand with your arms in front of you and your palms facing forward. Be Patient with Yourself . Fear that she would become paraylzed at the slightest injury. C4 Breathe more, shrug my shoulders to ignore. Precautions . 0 When you start to burn your fingers and not even realize that you have burned your fingers. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. ZDJ#=Kp2dy n Y R1W%i*e^L{B?ap) There are several different phases that we address during your evaluation with us so that you can get lasting results. hTP=k0+4t/!d4iwVrF636I^Zr{ae\a*+:Ln["-Z4\"opO;[dGSBtk?8#EP4`qd!vmoq kjld0fqls#g^b97C 0000079837 00000 n 0000064254 00000 n Ensure that patient can correctly complete log roll with positional changes. %PDF-1.5 % The goal is to foster independence . , and most often start presenting with symptoms in people in their 40-50s. Na2CO3(aq)+CaCl2(aq)CaCO3(s)+2NaCl(s). It took her 6 months after she initially spoke to usbooked her cervical fusion surgerythen cancelled the surgery to come to see us here at Hands-on Therapy Services. Therapy may be recommended. endstream endobj startxref 480 0 obj <> endobj trailer - WC Working with ortho patients was a hard change for me personally after almost solely working with neurological patients for the first year and a half of my OT career. It often develops over time rather than a single injury. Precautions: No lifting greater than 5 pounds until cleared by surgeon (usually by 4-6 weeks after procedure). The pain may feel dull ache, numbness/tingling, or an electrical sensation anywhere along the pathway of the nerve. I was less familiar with all of the precautions and the high pain levels, so I had to do a lot of self-teaching to get in the groove. For example, some adaptive utensils can . But first, let's discuss the reason why occupational therapy . Do not lift or carry objects that weigh more than 5 to 8 pounds. No passive stretching. Then we create a plan with you to help get rid of neck pain or the radiating numbness that is down in your fingers. H9SLeiZD_x}q#?/.NJ_b0 aIw;fq?4![AAAAj2:_/O}V*|C">i~{ S6x+(((tGyS/_>{|JoDo8 '%~ [AAAA#6s?{z?}&?M${O}tuJ=2 FsBQ&g.kL_"]2F"%>uPB`"ClJ0|x?MoSM26P~]l Cervical Radiculopathy is always serious as it is pinching on a nerve, and how bad the symptoms are to you is when it becomes a serious problem. Hk;K]]/'hRS4ciF&z,0Z#riY 2IJy/x4o,@ydbQfy\GJrcsc#*Fpe G /Dt* n5 `? ?Y^?m =J4|ll*o.ae. For a single-level ACDF a soft collar is used for 2 weeks. endobj Place your left hand on top of your head. 0000010602 00000 n endstream endobj 64 0 obj <>stream <> This is a great summary of precautions following hip, knee, and shoulder surgeries. Do not hold your breath during the exercises. The goals of physical therapy for someone with spinal stenosis include: Improving range of motion of the lumbar spine. 0000008704 00000 n stream A cervical fracture is a break in a vertebra (bone) in your neck. Numbness, weakness and pain can happen throughout the arm and hand. If exercises are the medication to help cervical radiculopathy getting the wrong dosage or the wrong medication can hurt more than help. 0000011284 00000 n Shrug your shoulders up toward your ears, then push your shoulders backward (see Figure 7). Occupational and, are both offered at Hands-On Therapy by our experienced therapists who provide a comprehensive approach to your care. therapy, soft tissue release, NDT/ Bobath assessment and treatment techniques, normal movement, vestibular rehabilitation, acupuncture, massage therapy, chronic pain management, exercise programming, and mindfulness. . 1 0 obj 0000002612 00000 n What would be most helpful for you? We will run through a comprehensive clinic testing to determine where the problems are, and find out which corrective movements work the best for you. Oftentimes, EMG testing can help rule out compression at the elbow and wrist area. You must have JavaScript enabled to use this form. dA#x`1&"~ S3 &6= ;p@h,+c.KbfEKCU <> 0000017782 00000 n Cervical AROM in pain-free range - No PROM (NO Stretching) Gentle 2-finger isometrics Scapular retraction, shoulder shrugs, chin tucks Stationary bike Treadmill - Walking progression program as tolerated Lifting to tolerance with proper body mechanics - Pain free Ice as needed GOALS Pain control 377 0 obj <> endobj They will also tell you when your incision (surgical cut) has healed well enough to start these exercises. A C6 spinal cord injury is a type of cervical spinal cord injury, the most severe type of injury. No lifting, pushing, or pulling anything over 5-10 pounds. A physical therapist and an occupational therapist may exercise your arms, legs, and hands. . 0000019079 00000 n Big Box vs. Personalized Care and Its Value, What is Thoracic Outlet Syndrome: Signs, Symptoms & Treatment. A really great intervention following the surgery is instructing them on putting it on without twisting. If there are precautions in place, these are the main ones you will see. We will look at your shoulders and hands to see where there is tension and the nerves may be stuck causing you more aggravation. % Start these exercises only when your healthcare provider tells you that its safe to do them. <> Medical Website Design by RedCastle Services. startxref endobj There is little high-quality evidence on the best nonoperative therapy for cervical radiculopathy. Ask patient to bring his knee towards his 0000010515 00000 n - Toilet transfers We will show you corrective movements that will help restore motion that may be lost and ease the tension and numbness of the nerves that go down your arm and hand. Occupational and/or Physical therapy can improve neck motion, improve muscle imbalances, and get rid of the symptoms. . Following a total hip replacement/arthroplasty, or other hip surgery following a fracture, your patient may have several precautions. While youre recovering, doing your daily activities may be harder for you. 60 0 obj <> endobj For more resources, visit www.mskcc.org/pe to search our virtual library. Qy=.tOB\JcMKh A physical therapist and an occupational therapist may exercise your arms, legs, and hands. 0000001158 00000 n (!{Yn4PBz.r:{"sE1DSN'$6n0%{*=]0xrjU!uFL~A^^M*oI~7S)\!8kFJveCfQU-77%OR\[+VH6Y_%'_ZL-*b:3|>MqhM#JVgv&-J1H- 0000023418 00000 n Thats how I usually describe it. That patient may have metastases that . Eating with adaptive utensils and plate guards. 4/Jk| 4,v. No matter the cause unless there is some other rare medical reason like cancer, it is possible to get rid of the pain and symptoms that you have radiating down your arm. Theres no commitment and no pressure. The spinal cord is like a tree trunk, and the spinal nerves are like the tree branches. - Shower transfer Further education regarding ADLs can include these general precautions: I hope this gives you basic crash course in working with your first orthopedic patients! The condition affects about 85 out of 100,000 people, and most often start presenting with symptoms in people in their 40-50s. OccupationalTherapy.com provides comprehensive courses offered for occupational therapy CEUs presented and authored by the leading experts, and delivered by the latest technology to meet the needs of the individual learner. 8 0 obj On the other hand, the individual may have no restrictions at all depending on the surgeon. If you would like more information about the services give us a call at 786-615-9879 or visit, What To Expect During An Occupational Therapy Session, Why You Shouldnt Do Occupational Therapy On Your Own, Dont Be Part of the Herd. k@X EjQ>jcM$&!T( Be Heard! LsL2/Ja%#L4kv. 1. This activity reviews the indications, contraindications, and techniques involved in performing . Cervical collar use- usually soft collar: 1 Level for 2 weeks, 2 Levels for 2-4 weeks, and 3 Levels This information will teach you how to do neck and shoulder exercises after your neck surgery. 0000014806 00000 n 201 0 obj <> endobj Activities of Daily Living After . If you have been diagnosed with cervical radiculopathy or you have neck pain and you THINK this sounds like you . SCI Mnemonic for cervical levels. Gentle flexion, extension, retraction active range of motion in 8\Oxw8URPPPfHB 0000019582 00000 n Sit or stand in front of a mirror, so you can see your face. This website uses cookies to improve your experience while you navigate through the website. Physical Therapy Standard of Care: Post-Operative Spine Surgery Case Type / Diagnosis: (diagnosis specific, impairment/ dysfunction specific/ICD 10 codes) ICD 10 Codes: M43.00 Spondyloysis M43.10 Spondylisthesis M50.30 Other cervical disc degeneration, unspecified cervical region M54.12 Radiculopathy, cervical region `F*^'KRhZ+ fvycR=S{H)$:QYP`gz2? endobj Total knee replacements will typically have less precautions to follow but can be more painful for the patient than hip replacements. After a full assessment, we develop a customized treatment program to meet each client's specific goals. 0000067920 00000 n 13 0 obj Have your palms facing forward and your thumbs pointing to the ceiling. - Bed transfers In addition to "neck" or "C-spine precautions", all trauma patients are cared for with thoracic and lumbar level . Whether your patient does or does not not have any specific precautions, ahip kit is recommended for lower body dressing due to the difficulty of bending forward to put on and take off shoes, socks, and pants. will also be invaluable for donning/doffing socks, shoes and threading pants. %%EOF /Tx BMC Since then, she is able to sleep, get in and out of bed without pain and numbness, works the computer without suffering, her arms going numb, and countless other activities that she was missing out on because of fear. The most common cause of spinal compression fractures is osteoporosis. Thanks so much for always having outstanding articles for our review! Just like anything else, not all therapy and therapists are created equal. It may be helpful to use a timer or clock to make sure you hold the stretches long enough. Hi Sarah, 0000069451 00000 n Gently step forward until you feel a gentle stretch across your chest and in front of your shoulders. [2] These conditions are referred to as radiculopathy and . Postoperative precautions and wearing a brace can make some self-care activities and activities of daily living difficult, if not impossible. My therapist's name is:_____ Date:_____ Spinal Fusion Safety Measures: NO hip flexion past 90 degrees No fat couches that you sink into. Reference guide for all the Precautions for Occupational Therapy Treatment. The reaction is, 2NO(g)+Br2(g)2NOBr(g)2 \mathrm { NO } ( g ) + \mathrm { Br } _ { 2 } ( g ) \rightleftharpoons 2 \mathrm { NOBr } ( g ) C5 Arms up high, bend my elbows, pretend to fly. Some insurance companies provide bedside commodes, but if not they can be, Lower body dressing is usually difficult for knee surgeries as well, so the. 0000015257 00000 n Do the exercises slowly and smoothly. Our scientists pursue every aspect of cancer researchfrom exploring the biology of genes and cells, to developing immune-based treatments, uncovering the causes of metastasis, and more. History of lower back issues even if you dont currently have pain. He covers all things occupational therapy as well as other topics including healthcare, wellness . - Dressing stick Place your left hand on top of your head. What would be the partial pressures of all species if NO\mathrm { NO }NO and Br2,\mathrm { Br } _ { 2 } ,Br2, both at an initial partial pressure of 0.30 atm, were allowed to come to equilibrium at this temperature? You may be able to move your shoulder and get full motion of your neck back before 3 months. 2. 0000064828 00000 n Spinal Precautions After Cervical Surgery. So, for this post, I wanted to make the transition easier for you by covering the biggest aspects occupational therapists encounter when working in orthopedics settings. endobj `Z&5 xR^g%!OqCK8b*S,@. The exercises in this resource will help make your neck and shoulder muscles stronger and more flexible. Laminectomy is a type of surgery in which a surgeon removes part or all of the vertebral bone (lamina). Neuromuscular reeducation of longus colli with pressure biofeedback (include arm and leg. Many of these surgeries are seen only 1-2 times in acute care followed by outpatient OT or PT services depending on the surgeons referral. Gently pull down your head toward your left shoulder, to stretch the muscles on the right side of your neck (see Figure 3). In terms of therapy and the no going back serious is when the symptoms start to change and become more permanent. Sit or stand with your arms at your sides. I appreciate you! Sit or stand and point your right arm downward. You also have the option to opt-out of these cookies. - Use of walker Call 800-692-4453. The worse case scenario is that the pain gets so bad that you cant sleep. Therapy One to two visits (if appropriate) Precautions Avoid bending, twisting, lifting, pushing and pulling 25 pounds or more for six weeks. For more in-depth home safety information, check out our article, No stepping backwards with surgical leg (lead with non-surgical leg when backing up to toilet, chair, etc. But opting out of some of these cookies may have an effect on your browsing experience. x}xTjBQjHB{3f(#$!6[I>c'-wW Upper body dressing is generally the most challenging task after this surgery. One thing we do really well at Hands-on THerapy Services, is to get your clear on what you can do before making any paid appointments. `)WwHBX ;1dVKO%s%I[`YXKe/xhd2W@ZZa~4TxBhhx`X9P3VS R5z"cxp%F?{;"Rd*}l^V%|sLPC"LN&D*II5I)+G-d=>zN>d[wHvN"8ES`m,ijd/]@;,2zcCA7 1|{HA[#]]","(~El%GlGU]VxlPq Ghhp;RXdx-~,u6-:%$yH^6{:H;Qg0}g zT[w&@;w&z% After 24 hours, you may take it off. 0000018681 00000 n The condition affects about 85 out of 100,000 people, and most often start presenting with . Physical therapy and occupational therapy will see you prior to your discharge from the hospital to make sure you are comfortable performing activities of daily living. Push your shoulders down and away from your ears. 2. <> As you breathe out, slowly and gently pull your abdomen toward your spine. Wear it too long and you will become stiff, causing more symptoms. Limit sitting, including in the car, to no more than 30 minutes at a time (standing/walk breaks). If youre still feeling stuck or if you need more information on a particular joint or protocol from an OT lens, be sure to dig into your Pedrettis Physical Dysfunctiontextbook or yourRadomsky Physical Dysfunctiontextbook, or whichever phys dys textbook your school required. For your reference, a steam iron weighs around 3 pounds while a half gallon of milk is 4 pounds. Hall, OT/L. I get all of my handouts from The Occupational Therapy Toolkit by Cheryl A. 0000005419 00000 n Your pain may worsen with certain neck movements. xref 4 0 obj Ask patient to sit up straight and support trunk with arms supporting trunk with no greater than 20 degree of trunk extension. After a Thoracic Spinal Cord Injury: The muscles affected by a thoracic level spinal injury include the hands, upper chest, abdominal muscles and trunk muscles. This will help your shoulder and neck move and work like they did before your surgery. 3 Assistance Levels. 0000017066 00000 n 0000007974 00000 n Use common sense, follow your precautions, and do not be afraid to ask for advice from your doctor. It can be months or even years. X#Kd p%hPiP&Ih~OF;}X^-{'qElRrY&W#LX[IMnpYD1]$kIVQC_=l*Y v(=2 2h xM`=%_}U4WW2J(#vJ+SW7eIb9_})ld"RGVyv&^rIRlR9R0s6CL ;0!'0q{^eU\'3p|~9bu~yT_@476*5D+6VWf%l+XWl~x L*^lbVgT&c>N.M 3dJogY09 qNNo7/Tns'if.y|D/&'_:7y%%I\.Hd]%:(_ey6C2BYL7uQ)Y". Before we go into how occupational/physical therapy can help with cervical radiculopathy, its important to explain what cervical radiculopathy is. Na2CO3(aq)+CaCl2(aq)CaCO3(s)+2NaCl(s)\mathrm{Na}_2 \mathrm{CO}_3(a q)+\mathrm{CaCl}_2(a q) \rightarrow \mathrm{CaCO}_3(s)+2 \mathrm{NaCl}(s) 2 Motor Function. Non-weightbearing: 0% of body weight. ), If youre still feeling stuck or if you need more information on a particular joint or protocol from an OT lens, be sure to dig into your. <> If you must lie on your uninvolved side, rest the arm of your involved side on a pillow in front of you. We will address the thoracic spine (ie mid back) to make sure you are able to move your neck without pain. The occupational therapist will <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> If you are committed to avoiding taking pills that dont work. She loves helping people with hand, neck and shoulder problems, because she knows how bad and debilitating they can get if not addressed and treated properly (once and for all!). Get the latest news and updates on MSKs cancer care and research breakthroughs sent straight to your inbox with our e-newsletters. . 7NP }D']ks$3xPip9jSEB*VVvY=4d6)NPXeH%8Bl#*gH7hH`xbl#t-7Z"- Dbx>X]yYVF&%|p#.V Trauma (e.g., car or skiing accidents), infection, and cancer can also cause spinal fractures. endobj There are several different phases that we address during your evaluation with us so that you can get lasting results. Partial weight-bearing: 20-50% of body weight. We have 7 cervical bones that make up your entire neck. 6Y'6s\1p^M1} P"sEOpt8Os6>omr k~O\bVx+oMj NU\o$2M+{JVw!1/[aH6OoS.!f }^%.-e{sz6}b#o d2+Uo%Pg)=h#_#S?;KGY~r Numbness, weakness and pain can happen throughout the arm and hand. Knowing things like cardiac precautions, hip precautions, cervical precautions is essential. <> There are three natural curves in the spine. 0000004501 00000 n Though it can lead to temporary symptomatic relief, there is limited data on its long-term safety and therapeutic efficacy. 247 33 The condition. No overhead lifting or activity. Not all of our clients come in with exactly the same problem, nor do they have the same goals. December 4, 2019. Follow these tips when doing your exercises. Making the switch from working in a non-orthopedic setting to an acute orthopedic setting can be a challenge for occupational therapists less familiar with patients following joint surgeries. . Breathe normally. Your care team cannot see anything you write on this feedback form. ), Noexternal rotation (turning outwards) of the surgical leg, No bending the hips forward past a90 degree angle (no forward flexion), For a list of detailed pictures of these hip precautions and home safety measures, you can print out any needed pages from this helpful, Whether your patient does or does not not have any specific precautions, a. for lower body dressing due to the difficulty of bending forward to put on and take off shoes, socks, and pants. - Shower chair/bench Educating Patients on Home Safety Following Orthopedic Surgery, Activities of Daily Living After Spinal Injury or Surgery, (Cleveland Shoulder Total Shoulder Arthroplasty/Hemiarthroplasty Protocol), The Best Splinting Guide for Occupational Therapists, 6 of the Best Occupational Therapy Forums, 10 Reasons Why OTs Should Be Using Occupation-Based Interventions. But, y ou may want to keep wearing your sling for comfort. Xm. Activities of Daily Living Back/Spinal Precautions This handout gives general guidelines to follow after spinal injury or surgery. LcH#*tN%A Always keep your shoulders back and relaxed, and your head retracted (pulled back). 0 - Sock aid For 4 weeks, no lifting >5#, then progress slowly. %%EOF 0000002991 00000 n Conservative treatments, like physical therapy, can help get pressure off spinal nerves, which will relieve pain and improve motion in your neck and shoulders. therapy visits. -Previous therapy: Document whether patient has had occupational or physical therapy for this or other conditions and what specific treatments were helpful or not helpful. This post was originally published on Feb 19, 2017 and updated on January 12, 2021 and February 8, 2023. John Muir Hospital. i|t>b"fRx,>E#`BXP, - Long-handled shoe horn E0&LfwAC)MDggggr2&c]N3lWz0 For a great resource to provide your patients, you can print out this. Telehealth and online sessions are available! 268 0 obj <>stream When ambulating, lead with the walker, then the surgical leg, followed by the non-surgical leg, being sure to keep the walker close, Keep the surgical leg elevated and extended with a towel roll under the heel when sitting or laying down, Avoid sitting in low chairs or surfaces. My OT Spot uses cookies to improve your experience. Pb/x$pg*>!Sir1{x `]o#p`vEf$WP'!.9YCz! . 2023 All rights reserved Hands on Therapy. 0 0000005200 00000 n C1-C3, I turn my head so I can see. Along with the previous precautions, patients will also need to be cognizant of their operative shoulder during ADLs. Assessed and provided comprehensive treatment to patients post-CVA, TBI, SCI, and . Please do not write your name or any personal information on this feedback form. endstream endobj 165 0 obj <>>>/Filter/Standard/Length 128/O(R3UfV=T;in)/P -1340/R 4/StmF/StdCF/StrF/StdCF/U(sC?. during bed mobility tasks to avoid twisting the spine. There are many people who are older and have boney changes who do not live in pain and I want you to know that it is possible for you to explore as well. %PDF-1.5 trailer Even if you have tried therapy before, and got no relief, give us a call, schedule an appointment, OR request a Free Discovery Visit! 0000003659 00000 n 10 0 obj Here at Hands-on Therapy Services, well talk to you first and get a history and find out what is your most important goal. Repeat this in the other direction. In these difficult times, we are here to help. This category only includes cookies that ensures basic functionalities and security features of the website. It's an excellent resource that I definitely recommend to every new grad. spine. xZKo8i!/joR@#C(r;C;;H"of4//~F m.H]Jp0yINsC If you're a patient at MSK and you need to reach a provider after. Precautions: Prevent excessive initial mobility or stress on tissues . The spinal cord connects to the brain and travels down through a canal in the vertebrae. Short Term Goals (within 3 months): The mother will demonstrate the home exercise program for cervical spine ROM on the child with 100% accuracy during 2 consecutive therapy visits within 1 month. She loves helping people with hand, neck and shoulder problems, because she knows how bad and debilitating they can get if not addressed and treated properly (once and for all!). %PDF-1.6 % Toe-touching weight-bearing: Up to 20% of body weight. -Fusion of any 2 of the 7 cervical vertebrae -Failure of division of cervical vertebrae during early fetal development -Leads to scoliosis and head tilt -Identified by cervical spine x-rays -Associated defects: anomalies of kidneys, ribs, cleft palate, respiratory problems, heart malformation Klippel-Feil Anomaly Ocular Torticollis