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Journal of Pediatric Neurology 2019; 17(04): 138-142
DOI: 10.1055/s-0038-1660829
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Management of Infants with Congenital Muscular Torticollis

Zheralldin Durguti
1   Physical and Rehabilitation Medicine Clinic, University Clinical Center of Kosovo, Prishtina – Kosova, Albania
,
Ardiana Murtezani
1   Physical and Rehabilitation Medicine Clinic, University Clinical Center of Kosovo, Prishtina – Kosova, Albania
,
Lidvana Spahiu
2   Pediatric Clinic, University Clinical Center of Kosovo, Prishtina – Kosova, Albania
,
Teuta Durguti
1   Physical and Rehabilitation Medicine Clinic, University Clinical Center of Kosovo, Prishtina – Kosova, Albania
,
Eqrem Gara
1   Physical and Rehabilitation Medicine Clinic, University Clinical Center of Kosovo, Prishtina – Kosova, Albania
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Publikationsverlauf

08. März 2018

11. Mai 2018

Publikationsdatum:
20. Juni 2018 (online)

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Abstract

Congenital muscular torticollis (CMT) is a deformation characterized by unilateral shortening of the sternocleidomastoid muscle resulting in lateral inclination of the neck associated with contralateral torsion. The purpose of this study was to assess the role of physical therapy in infants with CMT according to the age when treatment was started. The study was conducted in the Physical Therapy Clinic “Therapy” in Pristina for a period of 1 year from June 2016 to June 2017. The number of infants diagnosed with a CMT was 130 (71 girls and 59 boys). The infants were examined two times during the study period. The first visit was at the baseline and the second after the intervention. Three comparative groups are created based on time to start treatment. The infants were treated for 3 consecutive weeks with five sessions per week with the same therapeutic procedure. In the first examination of infants, there was no significant difference between the groups (chi-square test = 0.78, p = 0.08), whereas in the second examination after the 15 therapeutic sessions there was significant difference in the improvement of all the groups treated with physical therapy. Significant result was achieved in mean range of motion in infants of the group aged 3.1 to 6 months (mean = –35.9 ± 12.3, 95% confidence interval [CI], –39.3 to –32.4, p < 0.001) and in the mean side flexion of group aged 3.1 to 6 months (mean difference = –24.5 ± 7.9, 95% CI, –16.9 to –9.7, p < 0.001). While exercises in the 6- to 9-month age group have shown less success, because the time of appearance for physical therapy has been delayed (mean difference = –23.5 ± 10.7, 95% CI, –15.6 to –8.4, p < 0.001). From the results obtained from this study, we can conclude that the early start of the physical therapy gives much better results.

Keywords

congenital muscular torticollis - physical therapy - infant

Authors' Contributions

Durguti and Murtezani were overseeing this project, had full access of the data and did take responsibility for the integrity of the data.


Study Design: Durguti and Spahiu.


Instruction on the use of instruments for the outcome measures used in this study: Durguti, Murtezani, and Gara.


Analysis and interpretation of data: Durguti, Durguti, and Gara.


Manuscript preparation: Durguti, Murtezani, and Spahiu


Statistical Analysis: Durguti, Gara, and Durguti.


 

  • References

  • 1 Cheng JC, Tang SP, Chen TM, Wong MW, Wong EM. The clinical presentation and outcome of treatment of congenital muscular torticollis in infants--a study of 1,086 cases. J Pediatr Surg 2000; 35 (07) 1091-1096
    CrossrefPubMedSuche in Google Scholar
  • 2 Omidi-Kashani F, Hasankhani EG, Sharifi R, Mazlumi M. Is surgery recommended in adults with neglected congenital muscular torticollis? A prospective study. BMC Musculoskelet Disord 2008; 9 (01) 158
    CrossrefPubMedSuche in Google Scholar
  • 3 Celayir AC. Congenital muscular torticollis: early and intensive treatment is critical. A prospective study. Pediatr Int 2000; 42 (05) 504-507
    CrossrefPubMedSuche in Google Scholar
  • 4 Parikh SN, Crawford AH, Choudhury S. Magnetic resonance imaging in the evaluation of infantile torticollis. Orthopedics 2004; 27 (05) 509-515
    CrossrefPubMedSuche in Google Scholar
  • 5 Lincoln TL, Suen PW. Common rotational variations in children. J Am Acad Orthop Surg 2003; 11 (05) 312-320
    CrossrefPubMedSuche in Google Scholar
  • 6 Morrison DL, MacEwen GD. Congenital muscular torticollis: observations regarding clinical findings, associated conditions, and results of treatment. J Pediatr Orthop 1982; 2 (05) 500-505
    CrossrefPubMedSuche in Google Scholar
  • 7 d'Amato C. Pediatric spinal trauma: injuries in very young children. Clin Orthop Relat Res 2005; (432) 34-40
    PubMedSuche in Google Scholar
  • 8 Burstein FD. Long-term experience with endoscopic surgical treatment for congenital muscular torticollis in infants and children: a review of 85 cases. Plast Reconstr Surg 2004; 114 (02) 491-493
    CrossrefPubMedSuche in Google Scholar
  • 9 Petronic I, Brdar R, Cirovic D. , et al. Congenital muscular torticollis in children: distribution, treatment duration and outcome. Eur J Phys Rehabil Med 2010; 46 (02) 153-157
    PubMedSuche in Google Scholar
  • 10 Hale L, Piggot J. DipPhty M. The physiotherapy management of infants with congenital muscular torticollis: a survey of current practice in New Zealand. J Physiotherap 2009; 37 (03) 128
    PubMedSuche in Google Scholar
  • 11 Matin A, Islam MR, Roy RR, Das BK, Rakshit SC, Khan R. Management of congenital muscular torticollis under one year of age. J Shaheed Suhrawardy Med Coll 2012; 1 (02) 2-5
    PubMedSuche in Google Scholar
  • 12 Cooperman DR. The differential diagnosis of torticollis in children. Phys Occup Ther Pediatr 1997; 17 (02) 1-1
    PubMedSuche in Google Scholar
  • 13 World Health Organization (1978). International Classification of Diseases: Ninth Revision, basic tabulation list with alphabetic index. Geneva: World Health Organization. Available at: http://www.who.int/iris/handle/10665/39473
    PubMed
  • 14 Ta JH, Krishnan M. Management of congenital muscular torticollis in a child: a case report and review. Int J Pediatr Otorhinolaryngol 2012; 76 (11) 1543-1546
    CrossrefPubMedSuche in Google Scholar
  • 15 Ozalevli SS, Bayir N, Cavusoglu YH, Cakmak O. Is physical exercise necessary in the treatment of the congenital muscular torticollis. Pediatr Cerrahi Derg 2004; 18 (01) 21-24
    PubMedSuche in Google Scholar
  • 16 van Vlimmeren LA, Helders PJ, van Adrichem LN, Engelbert RH. Torticollis and plagiocephaly in infancy: therapeutic strategies. Pediatr Rehabil 2006; 9 (01) 40-46
    CrossrefPubMedSuche in Google Scholar
  • 17 Suhr MC, Oledzka M. Considerations and intervention in congenital muscular torticollis. Curr Opin Pediatr 2015; 27 (01) 75-81
    CrossrefPubMedSuche in Google Scholar
  • 18 Oledzka M, Suhr M. Postsurgical physical therapy management of congenital muscular torticollis. Pediatr Phys Ther 2017; 29 (02) 159-165
    CrossrefPubMedSuche in Google Scholar
  • 19 Strenk ML, Kiger M, Hawke JL, Mischnick A, Quatman-Yates C. Implementation of a quality improvement initiative: improved congenital muscular torticollis outcomes in a large hospital setting. Phys Ther 2017; 97 (06) 649-658
    CrossrefPubMedSuche in Google Scholar
  • 20 Kaplan SL, Coulter C, Fetters L. Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline: from the Section on Pediatrics of the American Physical Therapy Association. Pediatr Phys Ther 2013; 25 (04) 348-394
    CrossrefPubMedSuche in Google Scholar
  • 21 Carenzio G, Carlisi E, Morani I. , et al. Early rehabilitation treatment in newborns with congenital muscular torticollis. Eur J Phys Rehabil Med 2015; 51 (05) 539-545
    PubMedSuche in Google Scholar
  • 22 Lee K, Chung E, Lee BH. A comparison of outcomes of asymmetry in infants with congenital muscular torticollis according to age upon starting treatment. J Phys Ther Sci 2017; 29 (03) 543-547
    CrossrefPubMedSuche in Google Scholar
  • 23 Jung AY, Kang EY, Lee SH, Nam DH, Cheon JH, Kim HJ. Factors that affect the rehabilitation duration in patients with congenital muscular torticollis. Ann Rehabil Med 2015; 39 (01) 18-24
    CrossrefPubMedSuche in Google Scholar
  • 24 Hautopp L, Wester S, Bang B. , et al. Benefit of physiotherapeutic treatment in children with torticollis. Dan Med J 2014; 61 (12) A4970
    PubMedSuche in Google Scholar
  • 25 Hardgrib N, Rahbek O, Møller-Madsen B, Maimburg RD. Do obstetric risk factors truly influence the etiopathogenesis of congenital muscular torticollis?. J Orthop Traumatol 2017; 18 (04) 359-364
    CrossrefPubMedSuche in Google Scholar
  • 26 Nichter S. A clinical algorithm for early identification and intervention of cervical muscular torticollis. Clin Pediatr (Phila) 2016; 55 (06) 532-536
    CrossrefPubMedSuche in Google Scholar