Ann Rehabil Med.  2013 Apr;37(2):183-190. 10.5535/arm.2013.37.2.183.

The Cervical Range of Motion as a Factor Affecting Outcome in Patients With Congenital Muscular Torticollis

• Lee JY
• Koh SE
• Lee IS
• Jung H
• Lee J
• Kang JI
• Bang H

• KMID: 2165769
• DOI: http://doi.org/10.5535/arm.2013.37.2.183

Abstract

OBJECTIVE
To investigate the factors affecting rehabilitation outcomes in children with congenital muscular torticollis (CMT).
METHODS
We retrospectively reviewed the medical records of 347 patients who were clinically suspected as having CMT and performed neck ultrasonography to measure sternocleidomastoid (SCM) muscle thickness. Fifty-four patients met the inclusion criteria. Included were demographic characteristics as well as measurements of cervical range of motion (ROM), SCM muscle thickness, and the abnormal/normal (A/N) ratio, defined as the ratio of SCM muscle thickness on the affected to the unaffected side.
RESULTS
Subjects were divided into three groups depending on degree of cervical ROM (group 1A: ROM>60, n=12; group 1B: 60> or =ROM>30, n=31; group 1C: ROM< or =30, n=11), the SCM muscle thickness (Th) (group 2A: Th<1.2 cm, n=23; group 2B: 1.2< or =Th<1.4 cm, n=18; group 2C: Th> or =1.4 cm, n=13), and the A/N ratio (R) (group 3A: R<2.2, n=19; group 3B: 2.2< or =R<2.8, n=20; group 3C: R> or =2.8, n=15). We found that more limited cervical ROM corresponded to longer treatment duration. The average treatment duration was 4.55 months in group 1A, 5.87 months in group 1B, and 6.50 months in group 1C. SCM muscle thickness and the A/N ratio were not correlated with treatment duration.
CONCLUSION
Infants with CMT who were diagnosed earlier and had an earlier intervention had a shorter duration of rehabilitation. Initial cervical ROM is an important prognostic factor for predicting the rehabilitation outcome of patients with CMT.

Keyword

Congenital muscular torticollis; Range of motion; Rehabilitation; Prognosis

MeSH Terms

Child
Humans
Infant
Medical Records
Muscles
Neck
Prognosis
Range of Motion, Articular
Retrospective Studies
Torticollis
Treatment Outcome
Torticollis

Figure

• 

  Fig. 1 Ultrasonographic features of sternocleidomastoid muscle with longitudinal view in a child with congenital muscular torticollis. (A) Sternocleidomastoid muscle of affected side shows heterogenic echotexture and fusiform dilatation. (B) Sternocleidomastoid muscle of unaffected side shows homogenous echotexture.

• 

  Fig. 2 Measurement of range of motion of cervical rotation.

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