We recently started talking about positional plagiocephaly, and how one of the common causes involved was a restriction in range of motion in the neck that can be caused by a number of different factors. These are usually mechanical in nature, inter-uterine, at birth or postnatally. (1-3)
 
While there is little argument for the benefits of the involvement of physical therapy in the outcomes for plagiocephaly, one of the lesser explored complications of plagiocephaly is the potential for developmental delays.
 
The research is talking about a correlation between positional plagiocephaly and motor function, neurodevelopment, language and cognition. They are also highlighting the connection between the severity of the plagiocephaly and risk of developmental delays. (4-6) What all this means Is essentially that the palgiocephaly or flat heat In the past was seen as mostly a cosmetic or appearance issue, now research is showing correlations with all types of development mentioned above.
 
Again, like we showed in the last blog, the integration of physical therapy, like chiropractic, into the management of plagiocephaly is prudent, especially where there is restriction in range of motion and joint dysfunction identified. (1-3)
 
 

1. Ellwood, J., Draper-Rodi, J., & Carnes, D. (2020). The effectiveness and safety of conservative interventions for positional plagiocephaly and congenital muscular torticollis: a synthesis of systematic reviews and guidance. Chiropractic & manual therapies, 28(1), 1-11.
2. Marshall, J. M., & Shahzad, F. (2020). Safe sleep, plagiocephaly, and brachycephaly: assessment, risks, treatment, and when to refer. Pediatric annals, 49(10), e440-e447.
3. Pastor-Pons, I., Hidalgo-García, C., Lucha-López, M. O., Barrau-Lalmolda, M., Rodes-Pastor, I., Rodríguez-Fernández, Á. L., & Tricás-Moreno, J. M. (2021). Effectiveness of pediatric integrative manual therapy in cervical movement limitation in infants with positional plagiocephaly: a randomized controlled trial. Italian Journal of Pediatrics, 47(1), 1-12.
4. Rohde, J. F., Goyal, N. K., Slovin, S. R., Hossain, J., Pachter, L. M., & Di Guglielmo, M. D. (2021). Association of Positional Plagiocephaly and Developmental Delay Within a Primary Care Network. Journal of Developmental & Behavioral Pediatrics, 42(2), 128-134.
5. Kim, D. H., & Kwon, D. R. (2020). Neurodevelopmental delay according to severity of deformational plagiocephaly in children. Medicine, 99(28). 
6. Collett, B. R., Kartin, D., Wallace, E. R., Cunningham, M. L., & Speltz, M. L. (2020). Motor function in school-aged children with positional plagiocephaly or brachycephaly. Pediatric Physical Therapy, 32(2), 107-112.

The asymmetrical tonic neck reflex (ATNR) is a primitive reflex that babies exhibit in the first 6 months of life and it is an integral part of neural development.  Persistence of an ATNR in school-aged children may be associated with poor handwriting, poor written expression, eye tracking issues (reading), difficulty crossing the midline and poor hand-eye coordination.
 
A study by McPhillips and Sheehy (2004) looked at the correlation between reading level and ATNR reflex persistence.  The study put the children into 3 groups based on reading level (top, middle and lowest) and looked at the correlation between that and ATNR persistence.
 
It was found that the lowest reading group had a significantly higher average level of ATNR compared with the middle reading group and the top reading group.  It was also found that there was a significant difference between the lowest reading group and the top reading group on a standardised test of motor ability. This study highlights the high levels of primary reflex persistence in children with reading difficulties and it provides further evidence of the association between reading difficulties and movement difficulties in young children. 
 
A cross-sectional study by McPhillips and Black (2007) found that persistence of an ATNR was associated with lower core literacy skills in younger children. This study suggested that children with difficulties in reading, spelling and nonword reading showed high levels of ATNR persistence compared to the children without difficulties.
 
The findings of both of these studies are significant as it provides evidence of the association between reading difficulties, movement difficulties and literacy skills in young children with and without a retained ATNR. 
 
If you have any concerns about your child’s reading, movement or literacy skills, give our Practice a call and we can assess your child to see if they still have a retained ATNR and give further recommendation to help manage this.
 
References
McPhillips, M. and Sheehy, N., 2004. Prevalence of persistent primary reflexes and motor problems in children with reading difficulties. Dyslexia, 10(4), pp.316-338.
 
McPhillips, M. and Jordan-Black, J.A., 2007. Primary reflex persistence in children with reading difficulties (dyslexia): A cross-sectional study. Neuropsychologia, 45(4), pp.748-754

Joint pain can be related to many issues and firstly important causes such as fractures, infections and tumours need to be ruled out. We commonly see joint issues also due to muscle and nerve issues. Low back pain and neck pain are common things we see and help a lot of people with, however something you may not be as aware of is that joint pain can also be associated with inflammation from your diet.

Did you know that Osteoarthritis (OA) is the most prevalent type of arthritis in Australia, and it affects about 1.8 million Australians which is about 8% of the total population? Obesity increases the risk of developing OA by 2 fold to 10 fold in the knee joints but OA of the non-weight bearing joints of the hands is also increased in obese patients, clearly indicating that other factors are involved in the relationship between obesity and OA! (1).

By Diet we are specifically focusing on the part here that pertains to the types of fat intake. Sugar also has its issues but we will leave that discussion for another day.
Fatty acids (FA), as part of molecules or acting individually, have diverse functions in cells that range from structural “building blocks” of cell membranes to suppliers of energy and signalling molecules. The FA in cells derive either from outside your body sources or from within the body’s own synthesis. Some organisms require some essential FA compounds that either cannot be synthesized, or cannot be synthesized in sufficient quantities (2).

As a result of their anti-inflammatory actions, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) may have therapeutic efficacy in inflammatory diseases. These are some of the oils found in fish oils. Work with animal models of Rheumatoid arthritis (RA), colitis (abdomen pain) and asthma has demonstrated efficacy of fish oil and of mediators derived from EPA and DHA. There have been many clinical trials of fish oil in patients with inflammatory diseases. Many trials in RA report clinical improvements (e.g. improved patient assessed pain, decreased morning stiffness, fewer painful or tender joints and decreased use of NSAIDs), and when the trials have been pooled in meta-analyses, statistically significant clinical benefit has emerged (3,4). A few human trials, supported by findings from animal models, indicate that EPA and DHA have a role in stabilizing advanced atherosclerotic plaques, which could reduce cardiovascular events and mortality (5). Mice studies show that diets higher in specific types of polyunsaturated fatty acids decreased progression of OA and synovitis (joint inflammation).
​
If you would like to know more about Fatty Acids and joint pain we would love to see you in our practice.
 
References
(1)Sekar, S., Crawford, R., Xiao, Y. and Prasadam, I., 2017. Dietary fats and osteoarthritis: insights, evidences, and new horizons. Journal of cellular biochemistry, 118(3), pp.453-463.
(2)De Carvalho, C.C. and Caramujo, M.J., 2018. The various roles of fatty acids. Molecules, 23(10), p.2583.
(3)Fortin, P.R., Lew, R.A., Liang, M.H., Wright, E.A., Beckett, L.A., Chalmers, T.C. et al. (1995) Validation of a meta-analysis: the effects of fish oil in rheumatoid arthritis. J. Clin. Epidemiol. 48, 1379–1390 doi:10.1016/0895-4356(95)00028-3
(4)Goldberg, R.J. and Katz, J. (2009) A meta-analysis of the analgesic effects of ω-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain 129, 210–223 doi:10.1016/j.pain.2007.01.020
(5)73 Calder, P.C. (2017) New evidence that ω-3 fatty acids have a role in primary prevention of coronary heart disease. J. Public Health Emerg. 1, 35 doi:10.21037/jphe.2017.03.03