The TOT Collar

For the treatment of torticollis.

Congenital Muscular Torticollis is usually discovered in the first 6 to 8 weeks of life. It is characterized by a contracture of the sternocleidomastoid muscle, causing the head to be laterally flexed to the affected side and rotated to the opposite shoulder. If uncorrected, this posture may lead to plagiocephaly and a high thoracic scoliosis.

For further reading go to wikipedia.org/wiki/torticollis

For the treatment of Congenital Muscular Torticollis

The TOT Collar is an easy to use and effective therapy aid for infant muscular torticollis. The TOT Collar use is added to the conservative treatment of infants with congenital muscular torticollis. The TOT Collar is designed to provide a stimulus to the lateral aspect of the skull. The user moves away from this stimulus towards a new central corrected position.

Adoption of a new, normal head position provides the ability to reset perception of horizontal, and so maintain the corrected head position.

The TOT Collar™ is pre-assembled and ready to fit.

Caution: the child should not be left alone wearing this Collar.

Remove for sleeping.

Model #:

Child - TOT01
Adult - TOT02

How it Works & Indications for Use

The TOT Collar™ is designed to provide a noxious stimulus to the lateral aspect of the skull. The user moves away from this stimulus towards a new, central corrected position. Adoption of a new, normal head position provides the ability to reset perception of horizontal and so maintain the corrected head position.

The TOT Collar use is added to the conservative treatment of infants with congenital muscular torticollis if they are 4 months of age or older and show a consistent head tilt of 5 degrees or more. The infant must have adequate ROM (range of motion) and lateral head righting reaction (head control and strength) to lift his or her head away from the side of the Collar.

A loop of soft PVC tubing is bridged by two short nylon tubes. Varying sizes of tubes are packaged with the Collar. These tubes are positioned anterior and posterior to the crest of the trapezius. The PVC tubing is fastened with a connecting strap.

The TOT Collar™ is non toxic and washable.

Sizing and Fitting

Fitting Instructions

The TOT Collar is pre-assembled and ready to fit. There are two sizes: Adult and Child. The clear pvc tubing of the Collar is supplied at twice the circumference of the neck, plus 4”- 6” (10 cm - 15cm). The tubing is joined with an end connector.

The white tubes or struts are selected according to the amount of lateral tilt of the head. Extra tubes are supplied with the TOT Collar to allow for change in lateral tilt.

Tube A spans from posterior to the crest of the trapezius to the occiput.

Tube B from anterior to the crest of the trapezius to below the tip of the mastoid process. Avoid pressure on the mandible.

The tubes are short to start with and replaced by longer tubes as correction is achieved. If there is a significant amount of tilt then use very short tubes initially. Tubes can be trimmed to the exact length required.

For correct fit, the infant should be holding his or her head in midline, slightly away from the struts, and there should be room for at least one adult finger to fit between the top clear pvc tubing and the neck.

Fit the Collar loosely at first and ensure that the lateral tubes are the correct length and on the correct side. Snug up the Collar by hand to check the fit.

Remove the Collar from the child. Pull through the clear pvc tubing to remove the excess. Trim this tubing to length with scissors and reconnect with the end connector. Replace the Collar after each trim to check the fit.

Note: Be careful not to cut off too much of the clear tubing.

It cannot be reconnected if cut too short.