Factors related to the treatment duration of infants with congenital muscular torticollis

Abstract

Objective: Congenital muscular torticollis (CMT) is a disease with abnormal head and neck posture in infants. It affects the child's movement and development and can lead to complications. Therefore, this study aims to find out what factors influence the rehabilitation treatment duration of infants with CMT. Design: Cross-sectional study. Methods: The subjects were 63 infants under 90 days of age who were diagnosed with CMT. Age, thickness of the sternocleidomastoid muscle (SCM) on the affected and non-affected side, head tilt angle, and head rotation angle of the affected head in infants were collected. The ratio of muscle thickness was calculated from the thickness of the affected SCM and the thickness of the non-affected SCM (A/N ratio). All subjects underwent conservative physical therapy twice a week for 30 minutes, and the end of the treatment was when the angle of head tilt was normal or less than 5 degrees, and the treatment duration was calculated. Results: Age, thickness of affected SCM, and head tilt were significantly correlated with treatment duration (p<0.05). The thickness of the non-affected SCM, A/N ratio, and head rotation angle did not show any correlation with treatment duration. The factors affecting the treatment duration were head tilt and age, showing 21% explanatory power of adjusted R 2. Conclusions: The main factors affecting the treatment duration of infants with CMT are head tilt and age. Therefore, more attention should be directed to the infant's head tilt and age for effective physical therapy of infants with CMT.

Informing the Physical Therapy Management of Congenital Muscular Torticollis Clinical Practice Guideline: A Systematic Review

“…Five studies informed prognosis associated with treatment duration, clinical outcomes, and use of supplemental interventions 33–37 Table 4. includes data on participants, outcome measures, prognostic factors, and clinical implications of these studies.…”

“…A cohort study investigated factors influencing treatment duration in 63 infants under 3 months of age diagnosed with CMT 37. Treatment duration positively correlated with age, thickness of the SCM on the affected side, and head tilt angle 37.…”

“…The 2018 CMT CPG states that the prognoses for symptom resolution, episode-of-care, and/or the need to refer for more invasive interventions are related to age of initiation of treatment, severity classification, intervention intensity, presence of comorbidities, rate of change, and home program adherence 12. Newer evidence reaffirms this statement and adds information on age at initiation of treatment,34,37 severity classification,36 and effect of social determinants of health 36. The recommendation strength remains moderate.…”

“…Five studies informed prognosis associated with treatment duration, clinical outcomes, and use of supplemental interventions. [33][34][35][36][37] A cohort study investigated factors influencing treatment duration in 63 infants under 3 months of age diagnosed with CMT. 37 Treatment duration positively correlated with age, thickness of the SCM on the affected side, and head tilt angle.…”

“…[33][34][35][36][37] A cohort study investigated factors influencing treatment duration in 63 infants under 3 months of age diagnosed with CMT. 37 Treatment duration positively correlated with age, thickness of the SCM on the affected side, and head tilt angle. 37 Age and head tilt explained 21% of the variance in treatment duration 37 ; however, the study had a high risk of bias due to lack of acknowledgment of confounding variables that could impact the study results.…”