Commentary on “Associations Between Congenital Muscular Torticollis Severity and Physical Therapy Episode”

2020 ◽  
Vol 32 (4) ◽  
pp. 321-321
Author(s):  
Anne Pleva ◽  
Aimee Bruk
2018 ◽  
Vol 30 (4) ◽  
pp. 240-290 ◽  
Author(s):  
Sandra L. Kaplan ◽  
Colleen Coulter ◽  
Barbara Sargent

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 158
Author(s):  
Hwang ◽  
Shin ◽  
Choi ◽  
Jung ◽  
Yang

Congenital muscular torticollis (CMT) results from unilateral shortening of the sternocleidomastoid (SCM) muscle, usually associated with a fibrotic mass. Although CMT may resolve with physical therapy, some cases persist, resulting in long-term musculoskeletal problems. It is therefore helpful to be able to monitor and predict the outcomes of physical therapy. Shear-wave velocity (SWV) determined by acoustic radiation force impulse (ARFI) elastography can provide a quantitative measure of muscle stiffness. We therefore measured SCM SWV in 22 infants with unilateral CMT before and after 3 months of physical therapy and evaluated the relationships between SWV and SCM thickness and various clinical features, including cervical range of motion (ROM). SWV was initially higher and the ROM was smaller in affected muscles before physical therapy. SWV decreased significantly (2.33 ± 0.47 to 1.56 ± 0.63 m/s, p < 0.001), indicating reduced stiffness, and muscle thickness also decreased after physical therapy (15.64 ± 5.24 to 11.36 ± 5.71 mm, p < 0.001), both in line with increased neck ROM of rotation (64.77 ± 18.87 to 87.27 ± 6.31°, p < 0.001) and lateral flexion (37.50 ± 11.31 to 53.64 ± 9.41°, p < 0.001). However, the improved ROM more closely reflected the changes in SWV than in muscle thickness. These results suggest that a change in SWV detected by ARFI elastography could help to predict improvements in clinical outcomes, such as stiffness-related loss of motion, in patients with CMT undergoing physical therapy.


2018 ◽  
Vol 55 (9) ◽  
pp. 1282-1288
Author(s):  
Regina Fenton ◽  
Susan Gaetani ◽  
Zoe MacIsaac ◽  
Eric Ludwick ◽  
Lorelei Grunwaldt

Background: Many infants with congenital muscular torticollis (CMT) have deformational plagiocephaly (DP), and a small cohort also demonstrate mandibular asymmetry (MA). The aim of this retrospective study was to evaluate mandibular changes in these infants with previous computed tomography (CT) scans who underwent physical therapy (PT) to treat CMT. Methods: A retrospective study included patients presenting to a pediatric plastic surgery clinic from December 2010 to June 2012 with CMT, DP, and MA. A small subset of these patients initially received a 3D CT scan due to concern for craniosynostosis. An even smaller subset of these patients subsequently received a second 3D CT scan to evaluate for late-onset craniosynostosis. Patients were treated with PT for at least 4 months for CMT. Initial CT scans were retrospectively compared to subsequent CT scans to determine ramal height asymmetry changes. Clinical documentation was reviewed for evidence of MA changes, CMT improvement, and duration of PT. Results: Ten patients met inclusion criteria. Ramal height ratio (affected/unaffected) on initial CT was 0.87, which significantly improved on subsequent CT to 0.93 ( P < .05). None of the patients were diagnosed with craniosynostosis on initial CT. One patient was diagnosed with late-onset coronal craniosynostosis on subsequent CT. Conclusions: We identified a small cohort of infants with MA, CMT, and DP. These patients uniformly demonstrated decreased ramal height ipsilateral to the affected sternocleidomastoid muscle. Ramal asymmetry measured by ramal height ratios improved in all infants undergoing PT.


2019 ◽  
Vol 23 (3) ◽  
pp. 21-30
Author(s):  
Agata Michalska ◽  
Zbigniew Śliwiński ◽  
Justyna Pogorzelska ◽  
Marek Grabski ◽  
Jolanta Dudek ◽  
...  

Congenital muscular torticollis (CMT) is a condition manifested by unilateral thickening and/or shortening of the sternocleidomastoid muscle. It can lead to local or global consequences (i.e., forced position and limitation of mobility of the cervical spine and head, delay of motor development). Early recognition of CMT symptoms and the implementation of conservative treatment, considered effective in the majority of cases, are an important part of physical therapy in CMT. The aim of the study is to review literature presenting the methods of physical therapy in CMT and to create the authors’ own proposals for treatment, based on the results of this review. Based on subject-matter literature and our own experience, algorithms for the rehabilitation procedure have been proposed, presenting the general scheme of action in CMT and management depending on the clinical form and age of the child in whom therapy was started (up to 5 months and after 6 months). The authors’ proposed algorithm did not strictly specify the frequency of sessions with a physiotherapist, because this is the resultant of many factors. The main ones include the child's age on the day of initiation of therapy, the clinical form of torticollis, the presence of muscle tone disorders and/or skull asymmetry, but also, the correctness of performing exercises proposed as part of the home-based programme, regularity of therapy and compliance with postural programme principles.


2021 ◽  
pp. 83-85

Congenital muscular torticollis (CMT); is one of the musculoskeletal diseases seen in the neonatal and infant period. It is formed as a result of stretching the sternocleidomastoid (SCM) muscle in childhood. Due to unilateral contraction of the SCM muscle, ipsilateral head tilt, contralateral face and jaw rotation occur. Exercise and positioning in physical therapy constitute the conservative treatment of CMT. Hydrotherapy treatment has not been used in CMT cases. However, most of the CMT which are not treated early are resolved by surgical intervention. In this case, the effectiveness and success of exercise and hydrotherapy on the patient with CMT were presented.


2020 ◽  
Vol 32 (4) ◽  
pp. 314-320
Author(s):  
Kathryn C. R. Knudsen ◽  
Ryan P. Jacobson ◽  
Sandra L. Kaplan

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