Physical Therapy Management of Congenital Muscular Torticollis

Abstract

Infants with CMT are frequently referred to physical therapists (PTs) to treat their asymmetries. This evidence-based clinical practice guideline (CPG) provides guidance on which infants should be monitored, treated, and/or referred, and when and what PTs should treat. Based upon critical appraisal of literature and expert opinion, 16 action statements for screening, examination, intervention, and follow-up are linked with explicit levels of evidence. The CPG addresses referral, screening, examination and evaluation, prognosis, first-choice and supplemental interventions, consultation, discharge, follow-up, suggestions for implementation and compliance audits, flow sheets for referral paths and classification of CMT severity, and research recommendations.

Unresolved Congenital Torticollis and Its Consequences: A Report of 2 Cases

“…16 In addition to the therapeutic interventions discussed earlier, environmental adaptations and parent education are recommended as part of the treatment plan. 16 Another interesting observation in the 2 case studies presented here was the dominant right-handedness in the 6-year-old boy, who had head rotational fixation to the right in infancy, and the left-handedness in the 10-year-old, who had left rotational fixation of the head in infancy. A secondary functional deficit in congenital torticollis is asymmetrical use of the hands.…”

“…16 However, in addition to neck mobility, the overall development of the infant must be considered, such as neck and trunk active ROM and development of symmetrical movements. 16 In addition to the therapeutic interventions discussed earlier, environmental adaptations and parent education are recommended as part of the treatment plan. 16 Another interesting observation in the 2 case studies presented here was the dominant right-handedness in the 6-year-old boy, who had head rotational fixation to the right in infancy, and the left-handedness in the 10-year-old, who had left rotational fixation of the head in infancy.…”

“…16 Manual stretching is the most common evidence-based treatment for congenital torticollis. 16 However, in addition to neck mobility, the overall development of the infant must be considered, such as neck and trunk active ROM and development of symmetrical movements.…”

“…16 Manual stretching is the most common evidence-based treatment for congenital torticollis. 16 However, in addition to neck mobility, the overall development of the infant must be considered, such as neck and trunk active ROM and development of symmetrical movements. 16 In addition to the therapeutic interventions discussed earlier, environmental adaptations and parent education are recommended as part of the treatment plan.…”

Current Physiotherapy Management of Infants With Torticollis Among Physiotherapy Practitioners in Sri Lanka.

“…Muscle function scale (MFS) was used to assess the degree of symmetry between muscle function of the lateral flexors of the affected compared with the unaffected side (Kaplan et al, 2013). In Sri Lanka there was no scale as MFS to assess CMT patients according to our knowledge.…”