Purpose: Although pediatric physical therapists may evaluate and treat infants with both congenital muscular torticollis (CMT) and gastroesophageal reflux disorder (GERD), a literature review found only 1 article suggesting a connection between these diagnoses. This study investigates a correlation between CMT and GERD. Methods: A retrospective chart review spanning 5 years including 2519 infants younger than 12 months examined the correlation between CMT, GERD, and other comorbidities including developmental dysplasia of the hip, oligohydramnios, multiparity, and breech positioning. Results: The CMT cohort had a significantly higher rate of GERD versus the general population. For all age groups, the GERD rate was significantly higher in the CMT population than in the reference population. The rate of developmental dysplasia of the hip, oligohydramnios, and breech positioning was higher in infants with both CMT and GERD. Conclusions: The increased likelihood of infants with CMT also having GERD has clinical implications for the pediatric physical therapist.

How could I apply this information?"This prospective study examining the prevalence of gastroesophageal reflux disease (GERD) in infants diagnosed with congenital muscular torticollis (CMT) is a much-needed addition to the literature. As illustrated in Table 1, babies with CMT classification grades 1-3 comprise most babies with reflux (n = 42, or 89.4%). Clinically, physical therapists (PTs) could use this knowledge to educate and inform physicians as well as families on the need to address positioning options for the younger infant with GERD and gastroesophageal reflux.The I-GERQ-R tool assists parents, caregivers, and therapists in the identification of reflux. This tool could be provided to families as a source of information for PTs and as a springboard for discussion between physicians and families. Therapists should be mindful of the limits of their scope of practice when interpreting the results of this tool. "What should I be mindful about when applying this information?"As a parent of a child with both torticollis and GERD, it makes sense to me that research has proven the correlation between the two. I think the research proves very helpful in the treatment and early intervention of torticollis. Having had 2 children with GERD and torticollis/head flattening, I believe that the more research is done and proven that GERD can cause torticollis, the more likely early intervention of physical therapy will be recommended by pediatricians and gastroenterologists. My first child had GERD and wore a helmet for brachycephaly/plagiocephaly. Because we started physical therapy early with my second daughter, her torticollis is better and head flatness almost completely gone. Physical therapy sessions are also much less invasive than wearing a helmet for an extended period.Since GERD is often diagnosed earlier in an infant' s life than torticollis, I think it is crucial to continue pushing this research forward to hopefully have a referral to physical therapy sooner to have the best outcome possible.