The status of the cervical spine in preschool children with a history of congenital muscular torticollis

Abstract

Background: Infants with congenital muscular torticollis are born with an asymmetric range of motion and a muscular imbalance in the cervical spine, as a result of a shortening or excessive contraction of the sternocleidomastoid muscle. Purpose: The study aimed to investigate passive range of motion (PROM) for rotation and lateral flexion, and muscle function of the cervical spine in children that had a history of CMT as infants. Study design: a prospective cohort study. Patient sample: 58 children at the age of 3.5 to 5 years that had been treated for CMT have infants participated in the study. Method: PROM was measured with protractors and muscle function was estimated with a modified Muscle Function Scale. Data from infancy were taken from earlier records. Result: PROM in rotation of the neck was mean 98.7° and PROM in lateral flexion of the neck was mean 69.1°. Symmetric PROM of the neck was found in 74% of the children for rotation and in 88% of the children for lateral flexion. Multiple regression showed that gender and PROM in rotation as infants had a significant impact on asymmetric PROM. Forty-five percent of the children had some degree of muscular imbalance in the lateral flexors of the neck. Conclusion: Possible risk factors for later asymmetric PROM are: gender, birth weight, gestation week and PROM in rotation as infants. These factors ought to be taken into consideration when developing guidelines for long-term follow-up.

Share and Cite:

Öhman, A. (2013) The status of the cervical spine in preschool children with a history of congenital muscular torticollis. Open Journal of Therapy and Rehabilitation, 1, 31-35. doi: 10.4236/ojtr.2013.12006.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Cheng, J.C.Y., Wong, M.W.N., Tang, S.P., Chen, T.M.K., Shum, S.L.F. and Wong, M.A. (2001) Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants. Journal of Bone and Joint Surgery, 83, 679-687.
[2] Öhman, A. and Beckung, E. (2005) Functional and cosmetic status in children treated for congenital muscular torticollis as infants. Advances in Physiotherapy, 7, 135-140. http://dx.doi.org/10.1080/14038190500213836
[3] Öhman, A. and Beckung, E. (2008) Reference values for range of motion and muscle function in the neck—In infants. Pediatric Physical Therapy, 20, 53-58. http://dx.doi.org/10.1097/PEP.0b013e31815ebb27
[4] Stellwagen, L., Hubbard, E., Chambers, C. and Lyons, J.K. (2008) Torticollis, facial asymmetry and plagiocephaly in normal newborns. Archives of Disease in Childhood, 10, 827-831. http://dx.doi.org/10.1136/adc.2007.124123
[5] Lee, Y.T., Cho, S.K., Yoon, K., et al. (2011) Risk factors for intrauterine constraint are associated with ultrasonographically detected severe fibrosis in early congenital muscular torticollis. Journal of Pediatric Surgery, 46, 514-519. http://dx.doi.org/10.1016/j.jpedsurg.2010.08.003
[6] Chang, P.Y., Tan, C.K., Huang, Y.F., Sheu, J.C., Wang, N.L., Yeh, M.L. and Chen, C.C. (1996) Torticollis: A long-term follow-up study. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 37, 173-177.
[7] Öhman, A. and Beckung, E. (2012) A pilot study on changes in passive range of motion in the cervical spine, for children aged 0 - 5 years. Physiotherapy Theory and Practice, 29, 457-460. http://dx.doi.org/10.3109/09593985.2012.753495
[8] Öhman, A., Perbeck, K.E., Beckung, E. and Haglund-Åkerlind, Y. (2006) Functional and cosmetic status after surgery in congenital muscular torticollis. Advances in Physiotherapy, 8, 182-187. http://dx.doi.org/10.1080/14038190600780213
[9] Perbeck, K.E., Elfving, B., Haglund, Y. and Brogren, C.E. (2005) Intra-rater reliability in measuring range of motion in infants with congenital muscular torticollis. Advances in Physiotherapy, 7, 84-91. http://dx.doi.org/10.1080/14038190510010331
[10] Öhman, A., Nilsson, S. and Beckung, E. (2009) Validity and reliability of the Muscle Function Scale, aimed to assess the lateral flexors of the neck in infants. Physiotherapy Theory and Practice, 25, 129-137. http://dx.doi.org/10.1080/09593980802686904
[11] Binder, H., Eng, G.D., Gaiser, J.F. and Koch, B. (1987) Congenital muscular torticollis: Result of conservative management with long-term follow-up in 85 cases. Archives of Physical Medicine and Rehabilitation, 68, 222-225.
[12] Canale, S.T., Griffin, D.W. and Hubbard, C.N. (1982) Congenital muscular torticollis. Journal of Bone and Joint Surgery, 64, 810-816.
[13] Chen, M.M., Chang, H.C., Hisieh, C.F., Yen, M.F. and Chen, T.H.H. (2005) Predictive model for congenital muscular torticollis: Analysis of 1021 infants with sonography. Archives of Physical Medicine and Rehabilitation, 86, 2199-2203. http://dx.doi.org/10.1016/j.apmr.2005.05.010
[14] Jones, P. (1968) Torticollis in infancy and childhood. Charles C Thomas, Springfield, 17-21.
[15] Davis, J., Wenger, D. and Mubarak, S. (1993) Congenital muscular torticollis: Sequela of intrauterine or perinatal compartment syndrome. Journal of Pediatric Orthopaedics, 13, 141-147.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.