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Gross AR, Olson KA, Pool J, Basson A, Clewley D, Dice JL, Milne N. Spinal manipulation and mobilisation in paediatrics - an international evidence-based position statement for physiotherapists. J Man Manip Ther 2024:1-23. [PMID: 38855972 DOI: 10.1080/10669817.2024.2332026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/14/2024] [Indexed: 06/11/2024] Open
Abstract
INTRODUCTION An international taskforce of clinician-scientists was formed by specialty groups of World Physiotherapy - International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in Paediatrics (IOPTP) - to develop evidence-based practice position statements directing physiotherapists clinical reasoning for the safe and effective use of spinal manipulation and mobilisation for paediatric populations (<18 years) with varied musculoskeletal or non-musculoskeletal conditions. METHOD A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes). RESULTS Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.1. It is not recommended to perform:• Spinal manipulation and mobilisation on infants.• Cervical and lumbar spine manipulation on children.•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:• Spinal mobilisation and manipulation on adolescents;• Spinal mobilisation on children; or• Thoracic manipulation on children for neck-back pain only.3. No high certainty evidence to recommend these interventions was available.Reports of mild to severe harms exist; however, risk rates could not be determined. CONCLUSION Specific directives to guide physiotherapists' clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.
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Affiliation(s)
- Anita R Gross
- Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Kenneth A Olson
- Northern Rehab Physical Therapy Specialists, DeKalb, Illinois, USA
| | - Jan Pool
- HU University of Applied Sciences, Epidemiologist, Emeritus Senior Researcher, Utrecht, The Netherlands
| | - Annalie Basson
- Rehabilitation Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Derek Clewley
- Doctor of Physical Therapy Division, Duke University, Durham, USA
| | - Jenifer L Dice
- School of Physical Therapy, Texas Woman's University, Houston, TX, USA
| | - Nikki Milne
- THINK Paediatrics Research Group, Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- International Organisation of Physiotherapists in Paediatrics (IOPTP)
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Kim TH, Kim YC, Choi JW. Unipolar myomectomy for congenital muscular torticollis: A retrospective study. J Craniomaxillofac Surg 2024; 52:763-771. [PMID: 38616143 DOI: 10.1016/j.jcms.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/28/2024] [Accepted: 03/30/2024] [Indexed: 04/16/2024] Open
Abstract
In this study, unipolar myomectomy was used to address limited neck movement and tight muscles in pediatric, adolescent, and adult patients. A retrospective chart review was performed for patients from January 2006 to February 2023, who were diagnosed with congenital muscular torticollis and underwent a unipolar myomectomy. Outcome evaluation, adapted from the Cheng and Tang system - cervicomandibular angle (CMA), facial asymmetry, cranial asymmetry, tilting limitation (TL), rotation limitation (RL), subjective assessment, and residual contracture - included various parameters scored from 0 to 3 points and categorized as poor, fair, good, or excellent. In total, the data for 36 patients (21 males and 15 females) were analyzed. Participants were aged 0.8-38 years. Surgery improved CMA, RL, and TL, with no complications (12.2°-1.2°, 18.6°-5.2°, and 17.6°-6.5° for CMA, RL, and TL, respectively; p < 0.001). The mean overall score was comparable among different age groups (2.8 ± 0.5, 2.2 ± 0.62, and 2.1 ± 0.37 for the pediatric, adolescent, and adult groups, respectively). Within the limitations of the study it seems that unipolar myomectomy is a promising, effective surgical option for individuals of multiple age groups.
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Affiliation(s)
- Tae Hyung Kim
- Department of Plastic and Reconstructive Surgery, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young Chul Kim
- Department of Plastic and Reconstructive Surgery, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jong Woo Choi
- Department of Plastic and Reconstructive Surgery, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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Jianqiang M, Haitian L, Xiaohu F, Lv Z, Xiaohong M. Disease spectrum of torticollis in children and diagnostic flowchart: A retrospective, single-centre study. J Paediatr Child Health 2024. [PMID: 38655908 DOI: 10.1111/jpc.16551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/12/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
AIM To describe the disease spectrum of torticollis in Chinese children and to improve its diagnostic flowchart. METHODS A retrospective analysis was conducted at the Rehabilitation Department of Beijing Children's Hospital from 2017 to 2021. Patients were diagnosed and referred based on a diagnostic flowchart of torticollis. Detailed patient data were collected from the outpatient electronic medical record system. RESULTS A total of 2047 patients met the inclusion criteria. The top five conditions were congenital muscular torticollis (CMT) (76.6%), cerebral palsy (5.1%), ocular torticollis (4.7%), brachial plexus injury (1.9%) and atlantoaxial rotary subluxation (1.3%). CMT was most common in 0-2 year olds, cerebral palsy in 3-5 year olds, and atlantoaxial rotary subluxation in 7-12 year olds. The top five referral departments were orthopaedics, ophthalmology, otolaryngology, head and neck surgery, neurology and neurosurgery. CONCLUSIONS The disease spectrum of torticollis in children and the diagnostic flowchart provide important references for diagnosing torticollis, which necessitates multidisciplinary collaboration.
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Affiliation(s)
- Ma Jianqiang
- Department of Rehabilitation, Beijing Children's Hospital, Capital Medical University, National Center for Children 's Health, China, Beijing, China
| | - Li Haitian
- Department of Rehabilitation, Beijing Children's Hospital, Capital Medical University, National Center for Children 's Health, China, Beijing, China
| | - Fu Xiaohu
- Department of Rehabilitation, Beijing Children's Hospital, Capital Medical University, National Center for Children 's Health, China, Beijing, China
| | - Zhongli Lv
- Department of Rehabilitation, Beijing Children's Hospital, Capital Medical University, National Center for Children 's Health, China, Beijing, China
| | - Mu Xiaohong
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Rahlin M, Haney NB, Barnett J. Perception-Action Approach Versus Standard Care for Infants With Congenital Muscular Torticollis: A Pilot Single-Blind Randomized Controlled Trial. Phys Ther 2024; 104:pzae038. [PMID: 38484092 DOI: 10.1093/ptj/pzae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/22/2023] [Accepted: 03/12/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE The purposes of this pilot study were to compare short-term outcomes of the Perception-Action Approach (P-AA) and standard care based on 5 components of first-choice interventions listed in the congenital muscular torticollis (CMT) clinical practice guideline. Changes in postural alignment, symmetrical use of both sides of the body during movement and play, gross motor development, and behavior observed during therapy were considered. METHODS Thirty-two participants were enrolled in a 2-group (P-AA and standard care) randomized, single-blind trial with pre-posttest measures. Participants were infants with CMT, age range 5 to 35 weeks at enrollment. Outcome measures administered at initial and final evaluations included still photography, arthrodial goniometry, Muscle Function Scale, Alberta Infant Motor Scale, and Functional Symmetry Observation Scale. Participants in both groups attended 3 intervention sessions. Their behavior exhibited during therapy was compared using the Therapy Behavior Scale Version 2.2. RESULTS Data collection was interrupted by the COVID-19 pandemic lockdown. Twenty-four infants completed the study (10 in P-AA and 14 in the standard care group). There were no significant differences between the groups in performance at initial and final evaluations. Both groups improved on most outcome measures. The P-AA group made greater gains on the Functional Symmetry Observation Scale, and the Therapy Behavior Scale Version 2.2 scores were higher in the P-AA group; however, these results did not reach significance. CONCLUSION Results suggest that similar short-term outcomes may be obtained in infants with CMT undergoing P-AA and standard care interventions. Definitive conclusions regarding the efficacy of the P-AA in infants with CMT cannot be made at this time. Nevertheless, the pilot findings provide valuable preliminary data for a future efficacy trial, which will require funding. IMPACT This was the first randomized controlled trial to provide evidence for use of P-AA intervention in infants with CMT. LAY SUMMARY Compared to standard treatment, the Perception-Action Approach (P-AA) provided similar short-term benefits to infants with congenital muscular torticollis. The P-AA group participants demonstrated higher symmetry and behavior scores, which needs to be confirmed in a larger future study.
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Affiliation(s)
- Mary Rahlin
- Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Nancy B Haney
- Formerly of Department of Physical Therapy, Rady Children's Hospital, San Diego, California, USA
| | - Joyce Barnett
- Formerly of Ability Occupational Therapy Services, LLC, Anchorage, Alaska, USA
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Moses V, Deville C, Simpkins S, Wang J, Marlow T, Holley C, Briggs S, Sheffer O, Payne A, Pauline L, Lam T, Blasingim A, Graham T. Effects of adherence to treatment for repositioning therapy, physical therapy, and cranial remolding orthoses in infants with cranial deformation. J Rehabil Assist Technol Eng 2024; 11:20556683241250310. [PMID: 38694843 PMCID: PMC11062220 DOI: 10.1177/20556683241250310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/12/2024] [Indexed: 05/04/2024] Open
Abstract
Deformational head shapes are most often treated through repositioning therapy (RT) and/or cranial remolding orthotic (CRO) treatment. However, there is conflicting evidence about the effectiveness of each method, and treatment compliance is suspected to affect treatment effectiveness. This study examines participant adherence with these treatment methods and explores if cranial correction is related to compliance. This study also reviews effects of developmental milestones and explores other potential impacts on compliance. A total of 45 infants with cranial deformation were consented and those with congenital muscular torticollis (CMT) concurrently received physical therapy. Infants were followed from 2 to 12 months of age and initially assigned to RT. Caregivers continued RT until the head shape corrected, caregivers chose to switch to a CRO, or infants turned 12 months of age. All participants were scheduled for a final visit at 12 months of age. Throughout treatment, caregiver surveys were used to examine compliance and developmental milestones. Results show promise for future investigation into the relationship between treatment modalities and adherence with treatment for deformational head shapes. Our findings provide preliminary support that treatment adherence may be linked with treatment success and concurrent enrollment in physical therapy increases patient compliance.
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Affiliation(s)
- Victoria Moses
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Caitlin Deville
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Susan Simpkins
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jijia Wang
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tally Marlow
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cayman Holley
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shea Briggs
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Olivia Sheffer
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Amy Payne
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lindsay Pauline
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tristine Lam
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ashton Blasingim
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tiffany Graham
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Tillinghast AB, Greve KR, Le Cras SP. TOT Collar Use in Complex Case of Congenital Muscular Torticollis With Persistent Head Tilt. Pediatr Phys Ther 2024; 36:113-118. [PMID: 38127851 DOI: 10.1097/pep.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE The purposes of this case report were to (1) highlight the use and efficacy of the Tubular Orthosis for Torticollis (TOT) Collar in a prolonged and complex episode of care for an infant with congenital muscular torticollis (CMT) and (2) describe an infant with CMT receiving a physical therapy episode of care interrupted by the COVID-19 pandemic, leading to use of supplemental interventions. SUMMARY OF KEY POINTS The patient presented was an infant with CMT who received physical therapy treatment, including the TOT Collar, to resolve all symptoms. STATEMENT OF CONCLUSIONS The TOT Collar helped achieve midline head position after all treatment options were exhausted at the end of a lengthy episode of care impacted by the COVID-19 pandemic. RECOMMENDATION FOR CLINICAL PRACTICE The TOT Collar may be an appropriate supplemental intervention choice for infants with CMT whose symptoms do not resolve with first-choice interventions.
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Affiliation(s)
- Amanda B Tillinghast
- Division of Occupational Therapy and Physical Therapy (Drs Tillinghast, Greve, and Le Cras), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Rehabilitation, Exercise and Nutrition Sciences (Drs Greve and Le Cras), College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio
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Płomiński J, Olesińska J, Kamelska-Sadowska AM, Nowakowski JJ, Zaborowska-Sapeta K. Congenital Muscular Torticollis-Current Understanding and Perinatal Risk Factors: A Retrospective Analysis. Healthcare (Basel) 2023; 12:13. [PMID: 38200919 PMCID: PMC10778664 DOI: 10.3390/healthcare12010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Congenital muscular torticollis (CMT) is an asymmetrical head position resulting from structural changes in the sternocleidomastoid (SCM) muscle that occurs early during a child's development or due to perinatal trauma. Children with CMT exhibit a marked imbalance in tension between the SCMs. In a typical clinical picture, an ultrasound scan is performed to reveal characteristic lesions, such as tissue fibrosis or post-traumatic changes. An early diagnosis of CMT in newborns and the implementation of treatment offer the chance of a complete resolution. Torticollis treatment aims to restore the SCM's normal function. Surgical treatment is performed when conservative methods fail to improve the patient's condition. The indications that surgery is needed include a marked shortening of the SCM, persistent fibrosis in the muscle, constant head and facial asymmetry, and rotation or lateral flexion in the cervical spine restricted by >15°. Of all the newborn and infant anomalies, congenital torticollis is the third most common after hip dysplasia and equinovarus deformities. Some authors demonstrate that torticollis coexists with hip dysplasia. AIM The aim of this study was to collect data on infants referred to paediatric rehabilitation and to identify the risk factors associated with CMT in this group of patients, as well as to assess demographic and clinical characteristics concerning risk factors. MATERIALS AND METHODS The target population for this retrospective study consisted of 111 infants aged 0 to 5 months born in Poland and diagnosed with and undergoing treatment due to CMT. The following were determined: the relationship between the side of the CMT location and the type of delivery (caesarean section vs. vaginal), the relationship between the body weight at birth and the side of the CMT location, the relationship between the extent of SCM thickening and the type of delivery, and the incidence of CMT depending on the order of delivery. RESULTS AND CONCLUSIONS The data revealed that CMT is less common in female infants (n = 51, 46%) compared to male (n = 61, 54%) infants, in whom a greater birth weight was reported (p < 005). Seventy-six percent (76%) of the paediatric patients with CMT were the offspring of primipara mothers. More often, children born via vaginal delivery had left-sided torticollis with a more significant broadening of the SCM, as shown on ultrasound scans, than right-sided torticollis. Theories of torticollis development pathophysiology should be deepened and systematised, and further research is needed.
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Affiliation(s)
- Janusz Płomiński
- Prof. Adam Gruca Independent Public Clinical Hospital CMKP, 05-400 Otwock, Poland;
- Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Jolanta Olesińska
- Department of Physiotherapy, College of Rehabilitation, 01-234 Warsaw, Poland;
- Department of Physiotherapy, Prof. Jan Bogdanowicz Children’s Hospital, 03-924 Warsaw, Poland
| | - Anna Malwina Kamelska-Sadowska
- Department of Rehabilitation and Orthopedics, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
- Regional Specialised Children’s Hospital, 10-561 Olsztyn, Poland
| | - Jacek Józef Nowakowski
- Department of Ecology and Environmental Protection, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Katarzyna Zaborowska-Sapeta
- Department of Rehabilitation and Orthopedics, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
- Regional Specialised Children’s Hospital, 10-561 Olsztyn, Poland
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Rodríguez-Huguet M, Rodríguez-Almagro D, Rosety-Rodríguez MÁ, Vinolo-Gil MJ, Ayala-Martínez C, Góngora-Rodríguez J. Effectiveness of the Treatment of Physiotherapy in the Congenital Muscular Torticollis: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2023; 11:8. [PMID: 38275429 PMCID: PMC10814226 DOI: 10.3390/children11010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024]
Abstract
A single congenital muscular torticollis (CMT) is a postural musculoskeletal deformity and is characterized by the shortening or stiffness of the sternocleidomastoid muscle. The reported incidence of CMT ranges from 0.2% to 2%. The objective is to evaluate the effect of physical therapy programs on CMT. For the search, PubMed, Scopus, Web of Science, PEDro and Cochrane databases were used. Randomized controlled trials published between 2018 and 2023 have been included. This study follows the PRISMA 2020 statement and has been registered in the PROSPERO database. Finally, six studies were included. The cervical range of motion (ROM) in rotation was the most analyzed variable, followed by the ultrasound evaluation; one of the studies included the analysis of children's motor development with the Alberta scale. All research found benefits associated with soft tissue mobilization, passive stretching techniques and manual therapy of the cervical spine. In conclusion, it is possible to recommend manual therapy and passive stretching techniques for the treatment of CMT, with significant results on the cervical ROM.
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Affiliation(s)
- Manuel Rodríguez-Huguet
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.J.V.-G.); (J.G.-R.)
| | - Daniel Rodríguez-Almagro
- Department of Nursing, Physical Therapy and Medicine, University of Almería, 04120 Almería, Spain;
| | - Miguel Ángel Rosety-Rodríguez
- Move-It Research Group, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Puerta del Mar University Hospital, University of Cádiz, Plaza Fragela, s/n, 11003 Cádiz, Spain;
| | - Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.J.V.-G.); (J.G.-R.)
- Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Puerta del Mar, Hospital Puerto Real, Cádiz Bay-La Janda Health District, 11006 Cádiz, Spain
- Research Unit, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Puerta del Mar University Hospital, University of Cádiz, 11009 Cádiz, Spain
| | | | - Jorge Góngora-Rodríguez
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (M.J.V.-G.); (J.G.-R.)
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Zhao Z, Deng H, Li Y, Wang X, Tang G, Zeng Y, Xu H, Yang Q, Wu Z, Li S, Cui Z, Feng G, Fu G, Tang S, Xiong Z, Qiu X. Experience with the management of 2599 cases of congenital muscular torticollis and a multicenter epidemiological investigation in 17 hospitals in China. BMC Musculoskelet Disord 2023; 24:901. [PMID: 37980469 PMCID: PMC10657491 DOI: 10.1186/s12891-023-06983-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 10/21/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Congenital muscular torticollis (CMT) is a common musculoskeletal disease affecting infants and young children. If CMT is not treated correctly and timely, it can lead to limited head and neck movements, head and neck deviation, and abnormal posture. In order to improve patients' symptoms and alleviate the negative impact of the disease on their lives, we are committed to exploring the treatment of CMT. METHODS The general clinical and ultrasonographic data of 2599 children with CMT who received standardized treatment at Shenzhen Children's Hospital from 2004 to 2020 were retrospectively reviewed. According to given treatment, children with CMT were divided into the physiotherapy group, physiotherapy combined with glucocorticoid treatment group, and surgical treatment group. We divided children with CMT into local mass, uniform thickening, and atrophy according to ultrasound features. General clinical information, treatment, and ultrasound examination data in each group were compared. Additionally, electronic medical records of 2344 patients admitted due to CMT in 17 tertiary children's hospitals of China's Futang Research Center of Pediatric Development (FRCPD) from 2015 to 2019 were retrospectively analyzed. Data on sex, age, year of admission and discharge, and treatment costs during hospitalization were extracted from the first medical record pages according to the ICD codes. The data were assessed for normality using the Kolmogorov-Smirnov test. Depending on the data distribution, they were analyzed using parametric tests, such as the t-test, or non-parametric tests. Qualitative data are expressed as percentages (%) and analyzed using the chi-square or Fisher's exact probability test, with α = 0.05 as the test level. P < 0.05 was considered to be indicative of a statistically significant difference. RESULTS Three types of CMT were defined based on sternocleidomastoid muscle ultrasound examination characteristics: local mass, uniform thickening, and atrophy. Age at first diagnosis was 69.21 ± 108.41 days in local mass type group, 216.85 ± 324.09 days in uniform thickening group, and 417.88 ± 739.05 days in atrophy- type group; while age at first physiotherapy use was 94.06 ± 206.49 days, 255.00 ± 430.62 days, 540.92 ± 1059.29 respectively. The children included in local mass type group have shown a high success rate of conservative treatment, with a rate of 7.5% of children underwent surgery. Age at first diagnosis was 112.44 ± 224.12 days in the physiotherapy group, 115.87 ± 144.86 days in the physiotherapy combined with glucocorticoid treatment subgroup, whereas the age at first physiotherapy use was 137.38 ± 312.11 and 196.91 ± 344.26 days respectively. In the observation period (2015-2019) the mean age at surgery for CMT in 17 tertiary children's hospitals of the FRCPD was 50 months. Overall, 663 children with CMT were 1-2 years of age, accounting for the largest proportion (28.3%). Followed by 417 individuals (17.8%) were 7-14 years of age, indicating that there are still more children with CMT receiving surgical treatment later. CONCLUSIONS Early diagnosis and treatment are essential to improve the conservative treatment success rate and achieve good prognosis in children with CMT. Our team's concept for treating CMT is as follows: after diagnosing the children, we will adopt the standardized protocol of treatment, with physiotherapy combined with the injection of glucocorticoid drugs and SCM release surgery, when needed. This program has a high conservative treatment success rate and may facilitate the achievement of better prognosis and reduced teratogenicity rate.
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Affiliation(s)
- Zhenhui Zhao
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China
- China Medical University, Shenyang, Liaoning Province, P. R. China
| | - Hansheng Deng
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China
- Department of Biomedical Sciences, University of Sassari, 07100, Sassari, Italy
- Orthopaedic Department, Sassari University Hospital, 07100, Sassari, Italy
| | - Yuanheng Li
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, Guangdong Province, P. R. China
- The Guangdong-HongKong-Macau Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, Guangdong Province, P. R. China
| | - Xinyu Wang
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Gen Tang
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China
| | - Yueping Zeng
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hui Xu
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Qisong Yang
- Hefei Center for Disease Control and Prevention, Hefei, P. R. China
| | - Zhengyu Wu
- Hefei Cancer Hospital, Chinese Academy of Science, Hefei, P. R. China
| | - Shicheng Li
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China
| | - Zhiwen Cui
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China
| | - Guoshuang Feng
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Guibing Fu
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China.
| | - Shengping Tang
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China.
| | - Zhu Xiong
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China.
- China Medical University, Shenyang, Liaoning Province, P. R. China.
| | - Xin Qiu
- Guangdong Province, Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen Children's Hospital, Shenzhen, P. R. China.
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Obajeun OA, Abaza A, Jaramillo AP, Sid Idris F, Anis Shaikh H, Vahora I, Moparthi KP, Al Rushaidi MT, Muddam M, Hamid P. Congenital Torticollis in a Child With Cervical Spine Deformity: A Case Report and Literature Review. Cureus 2023; 15:e46098. [PMID: 37900372 PMCID: PMC10611916 DOI: 10.7759/cureus.46098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Congenital torticollis is an abnormal tilt of the neck in a newborn especially on the side of the pathology with the chin pointing toward the contralateral side. The most frequent cause is termed congenital muscular torticollis (CMT) which is a structural abnormality in the muscle of the neck called sternocleidomastoid muscle. There are also other causes of congenital torticollis that may arise such as anomalies of the cervical vertebrae, syndromic causes, and ocular defects. Diagnosing these other causes of congenital torticollis requires careful examination, cervical X-ray, CT scan, and MRI. The objective of this review is to create an awareness of the different types and causes of cervical spinal deformity. It also confirms that it is easy to misdiagnose these rarer causes of congenital torticollis as seen in a clinical vignette of a newborn who was managed for CMT for about one year with physical therapy and later turned out to have an associated hemivertebrae and fusion of the second and third cervical vertebrae. It is rare but it has the burden of huge financial and psychosocial impact.
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Affiliation(s)
- Omobolanle A Obajeun
- Pediatrics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Abdelrahman Abaza
- Pathology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Arturo P Jaramillo
- General Practice, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Faten Sid Idris
- Pediatrics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Humna Anis Shaikh
- Pediatrics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Ilma Vahora
- General Surgery, St. George's University School of Medicine, Chicago, USA
| | | | - Majdah T Al Rushaidi
- Psychology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | | | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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11
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Kim JW, Park YC, Han SH. Congenital Hemihyperplasia in an Infant with Ipsilateral Torticollis: A Case Report. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1352. [PMID: 37628351 PMCID: PMC10453255 DOI: 10.3390/children10081352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023]
Abstract
Hemihyperplasia is a kind of regional body growth asymmetry and can be a symptom of several congenital disorders and tumorous conditions. Torticollis is most commonly caused by asymmetric hypertrophy of the sternocleidomastoid muscle. Herein, we report a case of hemihyperplasia in an infant with ipsilateral torticollis. The baby was evaluated using physical examination and ultrasonography. We observed significant right-side torticollis that was ipsilateral to congenital right-side hemihypertrophy. No abnormal tumorous conditions were found during the evaluation in the pediatrics department. The patient was treated with physical therapy and exhibited mild improvements in torticollis and hemihyperplasia.
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Affiliation(s)
- Jun Woo Kim
- Department of Rehabilitation Medicine, Hanyang University College of Medicine Medical Center, 222-1, Seoul 04763, Republic of Korea; (J.W.K.); (Y.C.P.)
| | - Yu Chan Park
- Department of Rehabilitation Medicine, Hanyang University College of Medicine Medical Center, 222-1, Seoul 04763, Republic of Korea; (J.W.K.); (Y.C.P.)
| | - Seung Hoon Han
- Department of Rehabilitation Medicine, Hanyang University College of Medicine Medical Center, 222-1, Seoul 04763, Republic of Korea; (J.W.K.); (Y.C.P.)
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, 249-1, Guri-si 11923, Republic of Korea
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12
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Kwon DR, Cho SC. Efficacy of Intensive Inpatient Therapy in Infants with Congenital Muscular Torticollis Involving the Entire Sternocleidomastoid Muscle. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1088. [PMID: 37371319 DOI: 10.3390/children10061088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/07/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023]
Abstract
The efficacy and frequency of physiotherapy in the prognosis of congenital muscular torticollis (CMT) that involves the entire sternocleidomastoid (SCM) muscle continues to be unclear. This study investigated the therapeutic effect of intensive inpatient therapy given to infants with CMT that involves the whole SCM using clinical measurements and ultrasound (US). This study included 54 infants (27 boys and 27 girls; mean corrected age of 18.57 days) evaluated for CMT at our outpatient clinic from January 2014 to May 2021. The included patients were divided into three groups (groups 1, 2, and 3). Patients in group 1 underwent outpatient treatment 12 times. Patients in groups 2 and 3 underwent therapeutic exercise followed by US diathermy with microcurrent twice daily for 1 or 2 weeks, respectively. Passive range of motion of the cervical rotation (PCRROM) and SCM thickness were evaluated pre- and post-treatment. Among the three groups, the demographic data at baseline were not significantly different, SCM thickness and PCRROM were significantly decreased/increased at post-treatment compared to pre-treatment (p < 0.05), mean PCRROM change was significantly greater in group 3 (p < 0.05), and mean SCM thickness reduction between pre-treatment and 3 months post-treatment was significantly greater in groups 2 and 3 (p < 0.05). Therefore, intensive inpatient therapeutic exercise and US diathermy with microcurrent may enhance the prognosis of CMT involving the entire SCM muscle.
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Affiliation(s)
- Dong Rak Kwon
- Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Republic of Korea
| | - Sung Cheol Cho
- Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Republic of Korea
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13
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Kochav-Lev M, Bennett-Back O, Lotan M, Stein-Zamir C. The Use of the Alberta Infant Motor Scale (AIMS) as a Diagnostic Scale for Infants with Autism. Diagnostics (Basel) 2023; 13:diagnostics13061045. [PMID: 36980353 PMCID: PMC10047290 DOI: 10.3390/diagnostics13061045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Abstract
Autism spectrum disorder (ASD) is a group of developmental disabilities presenting difficulties in social interaction and language and an increased occurrence of cognitive, sensory, and motor gaps. Early intervention has been reported to improve the function of children with ASD. However, motor screening for children with ASD is difficult, as there are no specific tools for identifying this specific population. This study reports the results of using the Alberta Infant Motor Scale (AIMS), which assesses gross infant motor skills from ages 0 to 18 months, as a screening tool for detecting motor developmental delay (MDD) in small children with ASD. Methods: This retrospective cohort study included all children registered at one health care organization in Israel born between 2011 and 2017 (N = 240,299). Early childhood MDD was defined as having at least one recorded developmental physiotherapy (DPT) visit before the age of 2 years. Reasons for referral to DPT and the results of using AIMS as an appropriate tool for revealing developmental delays in infants with ASD are presented. Results: ASD diagnosis was reported in 1821 children (prevalence rate 0.75%). Of those, 388 (odds ratio 4.1, 95% CI 3.6–4.6) children were referred to DPT. Children with ASD mostly received DPT for motor delays (46.19%), torticollis (19.52%), developmental delay (15.48%), and preterm birth (7.38%). The use of AIMS as an early detection tool suggests that more than 87% of children with ASD and MDD present with a developmental delay or risk for one when using this scale. Conclusions: The prevalence of ASD among children referred to DPT for MDD is higher than its prevalence within the general population. The most common reasons for a child with ASD to be referred for DPT services are MMDs. AIMS was found to be a sensitive tool to pinpoint relevant candidates for ASD screening among children treated in DPT. Possible effects of the study: The use of AIMS as a relevant assessment scale for this group of clients is recommended. Training DPTs in identifying initial ASD signs and developing their clinical reasoning abilities will increase the chance of implementing early intervention with this group of clients.
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Affiliation(s)
- Mooly Kochav-Lev
- Child Development Institute, Meuhedet Health Services, Jerusalem 95464, Israel
- Correspondence:
| | - Odeya Bennett-Back
- Child Development Institute, Meuhedet Health Services, Jerusalem 95464, Israel
| | - Meir Lotan
- Department of Physiotherapy, Ariel University, Ariel 40700, Israel
| | - Chen Stein-Zamir
- Braun School of Public Health and Community Medicine, The Hebrew University, Jerusalem 91120, Israel
- Jerusalem District Health Office, Israel Ministry of Health, Jerusalem 9101002, Israel
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14
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Abstract
Early childhood affords rapid brain development and advancement of the motor system. In High-Risk Infant Follow-Up programs, watchful waiting and monitoring of infants at high risk is shifting toward active surveillance and early diagnosis, followed by immediate targeted very early interventions. Infants with delayed motor skills benefit from developmental care, NIDCAP, and generic or specific motor training. Infants with cerebral palsy benefit from enrichment, targeted skills interventions, and task-specific motor training at high intensity. Infants with degenerative conditions benefit from enrichment but also require accommodations such as powered mobility.
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Affiliation(s)
- Lynda McNamara
- The Children's Hospital Westmead Clinical School, The University of Sydney, Locked Bag 4001, Westmead, Sydney, NSW 2145, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, PO Box 171, Forestville, Sydney, NSW 2006, Australia
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, PO Box 171, Forestville, Sydney, NSW 2006, Australia.
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15
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Informing the Physical Therapy Management of Congenital Muscular Torticollis Clinical Practice Guideline: A Systematic Review. Pediatr Phys Ther 2023; 35:190-200. [PMID: 36637442 DOI: 10.1097/pep.0000000000000993] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To systematically review current evidence on the physical therapy assessment, intervention, and prognosis of congenital muscular torticollis (CMT) to inform the update to the 2018 CMT Clinical Practice Guideline (CPG). METHODS Six databases were searched for studies that informed assessment, intervention, and prognosis for physical therapy management of infants with CMT. RESULTS Fifteen studies were included. Four studies investigated the psychometric properties of new and established assessments. Six studies informed the feasibility and efficacy of first-choice and supplemental interventions including traditional Chinese medicine and neural and visceral manipulation. One qualitative study found that parents of infants with mild and severe CMT had different concerns. Five studies informed prognosis, including factors associated with treatment duration, clinical outcomes, and use of supplemental interventions. CONCLUSION Newer evidence reaffirms 5 of 17 recommendations of the 2018 CMT CPG and could increase the recommendation strength to strong for neck passive range of motion.
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16
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Camden C, Mulligan H, Cinar E, Gauvin C, Berbari J, Nugraha B, Gutenbrunner C. Perceived strengths and weaknesses of paediatric physiotherapy services: Results from an international survey. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1974. [PMID: 36103585 DOI: 10.1002/pri.1974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/09/2022] [Accepted: 08/28/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Ensuring access to high quality services in paediatric physiotherapy (PT) is important to respond to the diverse needs of children. The accessibility and quality of paediatric PT services has however never been explored internationally. The purpose of this study is to explore the perceived strengths, weaknesses, opportunities, and threats (SWOT) of paediatric PT services offered around the world. METHOD A cross-sectional survey design method was used with a subsample of physiotherapists (PTs) who had previously participated in an online survey. The survey used for this study included close- and open-ended questions about access to services and the SWOT of PT services within participants' country. Descriptive statistics were used to summarize quantitative data and a content analysis was performed on open-ended questions. RESULTS Overall, 47 PTs from 47 countries completed the survey; 36% of participants reported that free access was available to all children in their country while 34% stated that a referral was always required when accessing services. Lack of direct access, insufficient specialized PT, financial and geographical issues were the main perceived barriers to access services. Access also emerged as one of the nine themes following the SWOT analysis. Other themes included education, quality of PT approaches, PT practices, communication and cooperation, teamwork, government, resources, and attitudes of PTs. DISCUSSION Despite variations in accessing services and how services are delivered across countries, some similar themes influencing PTs practices were found. Future opportunities for PTs working with children should aim at optimizing the initial training and professional development of PTs in paediatrics, increasing access to services for all children and advocating for sustainable and well-coordinated models of care building on best practices.
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Affiliation(s)
- Chantal Camden
- School of Rehabilitation, Sherbrooke University, Sherbrooke, Québec, Canada.,Research Centre of the Sherbrooke University Hospital Centre, Sherbrooke, Québec, Canada
| | - Hilda Mulligan
- School of Physiotherapy, Otago University, Christchurch, New Zealand
| | - Eda Cinar
- Research Centre of the Sherbrooke University Hospital Centre, Sherbrooke, Québec, Canada.,Département de Psychoéducation, Sherbrooke University, Sherbrooke, Québec, Canada
| | - Cheyenne Gauvin
- School of Rehabilitation, Sherbrooke University, Sherbrooke, Québec, Canada
| | - Jade Berbari
- Research Centre of the Sherbrooke University Hospital Centre, Sherbrooke, Québec, Canada
| | - Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
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17
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Sinn CN, Rinaldi RJ, McLaughlin MJ. Botulinum toxin type A outcomes in infants with refractory congenital muscular torticollis. J Pediatr Rehabil Med 2023; 16:539-552. [PMID: 37005902 DOI: 10.3233/prm-210088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
PURPOSE The aim of this study was to determine the effectiveness of botulinum toxin type A (BoNT-A) injections in infants with congenital muscular torticollis (CMT) who were refractory to conservative management. METHODS This was a retrospective study in which all subjects included were seen between 2004 and 2013 and were deemed appropriate for BoNT-A injections. A total of 291 patients were reviewed for inclusion in the study, and 134 patients met the inclusion criteria. Each child was injected with 15-30 units of BoNT-A into each of the following muscles: ipsilateral sternocleidomastoid, upper trapezius, and scalene muscles. The key outcome and variable measurements analyzed included age at time of diagnosis, age at time of initiation of physical therapy, age at time of injection, total number of injection series utilized, muscles injected, and degrees of active and passive cervical rotation and lateral flexion pre- and post-injection. A successful outcome was documented if a child could achieve 45° of active lateral flexion and 80° of active cervical rotation post-injection. Secondary variables including sex, age at time of injection, number of injection series utilized, surgery required, adverse effects of botulinum toxin, presence of plagiocephaly, side of torticollis, orthosis used, presence of hip dysplasia, skeletal anomalies, complications during pregnancy or birth, and any other pertinent information regarding the delivery were also measured. RESULTS Based on this criteria, 82 children (61%) had successful outcomes. However, only four of the 134 patients required surgical correction. CONCLUSION BoNT-A may be an effective and safe method for treatment in refractory cases of congenital muscular torticollis.
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Affiliation(s)
- Clarice N Sinn
- University of Texas Southwestern Medical Center, Division of Pediatric Rehabilitation Medicine, Dallas, TX, USA
| | - Robert J Rinaldi
- University of Texas Southwestern Medical Center, Division of Pediatric Rehabilitation Medicine, Dallas, TX, USA
| | - Matthew J McLaughlin
- Children's Mercy Hospital, Division of Rehabilitation Medicine, Kansas City, MO, USA
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18
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Kim E, Choi J, Min SY. Combined effect of external treatment of herbal medicine and tuina in congenital muscular torticollis: Systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e32086. [PMID: 36482534 PMCID: PMC9726427 DOI: 10.1097/md.0000000000032086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Congenital muscular torticollis (CMT) is the third most common musculoskeletal disease in children. With no standardized treatment method hence, so it is necessary to find an effective treatment method that can be received comfortably by children. This review assessed the efficacy of an external treatment of herbal medicine (ETHM) with tuina for CMT in children. METHODS This study searched the English, Chinese, and Korean databases (total of 10) until June 7 2022, without any language restrictions. All included studies were randomized clinical trials (RCTs) of ETHM with tuina as an intervention comparted to the same tuina alone according to the inclusion and exclusion criteria. The mean differences (MD), standardized mean differences (SMD), risk ratio (RR) with the 95% confidence interval (CI), and risk of bias (ROBs) were calculated using Review Manager Version 5.4 software. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) rating system was used to assess the quality of evidence. The publication bias was evaluated using a funnel plot, the Egger test, the fail-safe N test, and the Duval and Tweedle's trim and fill method using Review Manager Version 5.4 software, the software R Version 4.1.1 and R studio Version 1.4.1106 program. RESULTS Nineteen RCTs with 1710 patients were included in the meta-analysis. ETHM plus tuina improved the outcomes of the total effective rate (TER) [RR 1.21, 95% CI:1.15 to 1.26, P < .001], sternocleidomastoid (SCM) muscle thickness [MD: -1.82, 95% CI: -2.23 to -1.41, P < .001], cervical rotation range [MD: 13.43, 95% CI: 10.41-16.45, P < .001] and lateral flexion range [MD: 8.50, 95% CI: 6.15-10.85, P < .001], tissue elasticity grade [SMD: -0.46; 95% CI: -0.71 to -0.22, P = .0002], muscle elasticity scores [RR: 1.56; 95% CI: 1.04 to 2.34, P = .03], and clinical symptom and sign scores [SMD: -0.78; 95% CI: -1.09 to -0.47, P < .001]. CONCLUSIONS ETHM plus tuina have a combined effect on CMT children. However, further studies with high-quality clinical trials are needed to obtain more robust clinical evidence.
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Affiliation(s)
- Eunjin Kim
- Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Bundang Medical Center, Bun-dang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jungyoon Choi
- Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Jung-gu, Seoul, Republic of Korea
| | - Sang Yeon Min
- Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Ilsan Medical Center, Goyang-si, Gyeonggi-do, Republic of Korea
- * Correspondence: Sang Yeon Min, Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Ilsan Medical Center, Dongguk-ro 27, Ilsandong-gu, Goyang-si, Gyeonggi-do 10326, Republic of Korea (e-mail: )
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19
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Jeong KY, Lee HJ, Yim SY. The usefulness, reliability, and quality of YouTube video clips on congenital muscular torticollis: A STROBE compliant study. Medicine (Baltimore) 2022; 101:e30502. [PMID: 36123913 PMCID: PMC9478286 DOI: 10.1097/md.0000000000030502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to evaluate the usefulness, reliability, quality, and related characteristics of YouTube video clips on congenital muscular torticollis (CMT). This cross-sectional study analyzed 47 YouTube video clips on CMT. They were classified as either useful or misleading by 2 rehabilitation doctors. The modified DISCERN tool and the Global Quality Scale (GQS) were used to evaluate their reliability and quality. An analysis was conducted using the characteristics, such as presenters, ownership of YouTube channel accounts, countries, contents, and the video popularity. Of the 47 YouTube video clips, 8 (17%) were evaluated as misleading, which indicated that they included at least one scientifically unproven piece of information on CMT or more. They were less reliable and of lower quality than the useful video clips. The video clips presented by healthcare professionals were more useful compared to those presented by others (P = .015). However, the video popularity was not related to its usefulness. The reliability and quality (3.70 ± 0.82 vs 0.75 ± 0.50 and 2.95 ± 1.21 vs 1.50 ± 1.00) assessed by the modified DISCERN tool and GQS, respectively, were significantly higher in the video clips presented by healthcare professionals compared to those presented by others. There were misleading YouTube video clips on CMT. Video clips presented by healthcare professionals could be more useful, reliable, and of better quality. The popularity of the video clips does not indicate more usefulness, reliability, and better quality. YouTube viewers should be aware of these findings. We recommend that the viewers preferentially choose video clips on CMT presented by healthcare professionals, not by the video popularity.
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Affiliation(s)
- Kil-Yong Jeong
- The Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hyun Jung Lee
- Department of Physical Medicine and Rehabilitation, Jeju National University Hospital, Jeju Special Self-Governing Province, Republic of Korea
| | - Shin-Young Yim
- The Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Republic of Korea
- *Correspondence: Shin-Young Yim, The Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon 16499, Republic of Korea (e-mail: )
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Minghelli B, Vitorino NGD. Incidence of Congenital Muscular Torticollis in Babies from Southern Portugal: Types, Age of Diagnosis and Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9133. [PMID: 35897505 PMCID: PMC9332427 DOI: 10.3390/ijerph19159133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 12/01/2022]
Abstract
Congenital torticollis (CMT) is the most common type of torticollis and is defined as a unilateral contracture of the sternocleidomastoid muscle resulting in lateral head tilt associated with contralateral rotation, and early detection and treatment may present a high probability of recovery of head posture symmetry. This study aimed to verify the incidence of torticollis in babies born in southern Portugal types, age of diagnosis and the risk factors. This study comprised 6565 infants born in the south of Portugal at Algarve University Hospital Center, Portimão unit during a 5-year period (January 2016 to December 2020). The cases diagnosed with torticollis referred to the Pediatrics and Pediatric Physiatrist consultations at this hospital were included. 118 babies—77 (65.3%) male and 41 (34.7%) female—were diagnosed with torticollis. The incidence of a 5-year period was 1.5%. Spontaneous vaginal delivery was prevalent (n = 56; 47.5%), with 106 (89.8%) deliveries with cephalic presentation. 53 (44.9%) cases of torticollis were classified as postural, 37 (31.4%) as muscular torticollis with joint limitation and 28 (23.7%) as congenital torticollis (with the presence of a nodule). Postural torticollis was diagnosed at an average age of 70.14 days, muscular torticollis with joint limitation at an average of 64.12 days and congenital torticollis at 33.25 days (p < 0.001). Plagiocephaly was present in 48 (40.7%) babies with torticollis (p = 0.005) and joint limitation in 53 (44.9%) babies (p < 0.001). The data obtained revealed a low incidence of CMT, with the majority being classified as postural. The age of diagnosis varied between 33 to 70 days from birth. The baby’s gender, mode of delivery and the fetal presentation during delivery did not show a statistically significant association with the presence of torticollis. Despite presenting a low incidence, it is important to mention the importance of professional health intervention in the implementation of prevention strategies.
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Affiliation(s)
- Beatriz Minghelli
- Escola Superior de Saúde Jean Piaget Algarve, Instituto Piaget, 8300-025 Silves, Portugal
- Research in Education and Community Intervention (RECI), Instituto Piaget, 1950-157 Lisbon, Portugal
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21
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Infants With Congenital Muscular Torticollis: Demographic Factors, Clinical Characteristics, and Physical Therapy Episode of Care. Pediatr Phys Ther 2022; 34:343-351. [PMID: 35616483 DOI: 10.1097/pep.0000000000000907] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe demographic factors, baseline characteristics, and physical therapy episodes in infants with congenital muscular torticollis (CMT), examine groups based on physical therapy completion, and identify implications for clinical practice. METHODS Retrospective data were extracted from a single-site registry of 445 infants with CMT. RESULTS Most infants were male (57%), Caucasian (63%), and firstborn (50%), with torticollis detected by 3 months old (89%) with a left (51%), mild (72%) CMT presentation. Cervical range of motion (ROM) limitations were greatest in passive lateral flexion and active rotation. Sixty-seven percent of infants completed an episode of physical therapy, 25% completed a partial episode, and 8% did not attend visits following the initial examination. Age at examination, ROM, and muscle function differed significantly between groups. CONCLUSIONS Physical therapists may use clinical registry data to inform practice for timing of referral, frequency of care, and clinician training to manage infants with CMT.
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22
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Abstract
PURPOSE To describe supplemental intervention (SI) frequency in infants with congenital muscular torticollis (CMT) and compare groups of infants who received first-choice intervention only to infants who received SI. METHODS Data were retrospectively extracted from a registry. Baseline and treatment variables were collected and analyzed. RESULTS The cohort included 907 infants with 85 receiving SI. Order of SI frequency was kinesiological tape, manual techniques, tubular orthosis for torticollis (TOT) collar, and the Benik system. Statistically significant differences were found in baseline age, passive cervical range of motion (ROM), muscle function, and treatment time between groups. A positive association was found for CMT presentation, classification grade, plagiocephaly type, and external referrals between groups. CONCLUSIONS Nine percent of infants received SI, most frequently kinesiological tape. Infants who received SI had larger baseline passive ROM and muscle function differences and more visits over a longer duration but had similar CMT resolution. Education is needed when using SI.
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23
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Commentary on "Infants With Congenital Muscular Torticollis: Demographic Factors, Clinical Characteristics, and Physical Therapy Episode of Care". Pediatr Phys Ther 2022; 34:352. [PMID: 35776973 DOI: 10.1097/pep.0000000000000931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Infants With Torticollis Who Changed Head Presentation During A Physical Therapy Episode. Pediatr Phys Ther 2022; 34:185-191. [PMID: 35385451 DOI: 10.1097/pep.0000000000000879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study is to describe infants with congenital muscular torticollis (CMT) who changed head presentation during an episode of physical therapy. METHODS Data were extracted from electronic medical records between January 2015 and December 2018 to describe infants with CMT who changed presentation. RESULTS Eighty-nine infants met criteria (predominantly male, non-Hispanic, White, with private insurance). Torticollis symptoms were noticed by 3 months in 90% of infants with a physical therapy examination before 6 months in 100% of infants. Most infants had early mild CMT with abnormal head shape and greater limitation in active cervical range of motion (ROM) than passive cervical ROM. Clinicians frequently recommended weekly physical therapy that included first- choice and supplemental interventions. Episodes of care averaged 7 visits over 64 days with 73% of infants meeting goals. CONCLUSION Physical therapists should recognize that infants with CMT may change presentation but benefit from physical therapy to resolve symptoms.Digital Abstract available at: http://links.lww.com/PPT/A366.
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Bess LK, Costa J, Nguygen ATH, Amankwah E, Wilsey MJ. Prevalence of Gastroesophageal Reflux Disease in Infants With Congenital Muscular Torticollis: A Prospective Cohort Study. Pediatr Phys Ther 2022; 34:180-183. [PMID: 35385449 DOI: 10.1097/pep.0000000000000883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Clinical experience suggests that gastroesophageal reflux disease (GERD) occurs commonly in infants with congenital muscular torticollis (CMT). However, this is an understudied topic and prospective studies are absent. We determine the prevalence of GERD in infants with CMT, comparing clinical characteristics between CMT infants with and without GERD, and identifying infants with potentially undiagnosed GERD. METHODS A prospective cohort study of 155 infants with CMT younger than 12 months with and without GERD was evaluated by pediatric physical therapists. RESULTS GERD prevalence was 30.3%, including 6 (3.9%) infants with undiagnosed GERD. Demographic and clinical characteristics were similar in CMT infants with and without GERD. CONCLUSIONS This is the first prospective cohort study determining the prevalence of GERD in infants referred for evaluation of CMT. Further prospective studies are needed to determine whether early intervention and treatment of GERD improves outcomes in infants with CMT (see Supplemental Digital Content 1, available at: http://links.lww.com/PPT/A369).
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Affiliation(s)
- Laura K Bess
- Pediatric Physical Therapy (Dr Bess), Johns Hopkins All Children's Hospital, St Petersburg, Florida; School of Physical Therapy (Dr Costa), Gannon University, Ruskin, Florida; Pediatric Physical Therapy (Dr Costa), Children's Therapy Solutions, Bradenton, Florida; Departments of Health Informatics (Mr Nguygen and Dr Amankwah) and Pediatric Gastroenterology (Dr Wilsey), Johns Hopkins All Children's Hospital, St Petersburg, Florida
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Commentary on "Infants With Torticollis Who Changed Head Presentation During A Physical Therapy Episode". Pediatr Phys Ther 2022; 34:192. [PMID: 35385452 DOI: 10.1097/pep.0000000000000893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kim E, Choi J, Min SY. External treatment of herbal medicine with tuina in congenital muscular torticollis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29035. [PMID: 35451412 PMCID: PMC8913123 DOI: 10.1097/md.0000000000029035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND This study is the protocol to evaluate the clinical evidence for external treatments using herbal medicine (ETHM) with tuina as a congenital muscular treatment (CMT) in pediatrics. METHODS Eleven databases will be searched until June 2022, without any language restrictions: four English databases (MEDLINE, Pubmed, EMBASE, and The Cochrane Central Register of Database of Controlled Trials), three Chinese databases (China National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan Fang Database), and four Korean electronic databases (Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, National Digital Science Links, and Research Information Sharing Service). This review will include randomized clinical trials (RCTs) of ETHM with tuina as an intervention versus the same tuina. All published RCTs for any ETHM for CMT will be included. Non-RCTs, RCT protocol, animal studies, case reports, reviews, and surveys will be excluded. The methodological quality assessment will be performed using the Cochrane risk of bias (ROBs). Review Manager version 5.4. will be used for the data synthesis and quantitative analysis. RESULTS AND DISCUSSIONS The systematic review and meta-analysis will provide evidence for ETHM as a treatment of CMT. The evidence can help clinicians and patients recognize more effective therapeutic and safe inventions. INPLASY REGISTRATION NUMBER INPLASY202210017.
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Affiliation(s)
- Eunjin Kim
- Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Bundang Medical Center, Republic of Korea
| | - Jungyoon Choi
- Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Republic of Korea
| | - Sang Yeon Min
- Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Republic of Korea
- Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Ilsan Medical Center, Republic of Korea
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Commentary on "Analysis of Spontaneous Movements in Infants With Torticollis". Pediatr Phys Ther 2022; 34:22. [PMID: 34958328 DOI: 10.1097/pep.0000000000000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
PURPOSE This study aimed to investigate whether the movements and postures of 3- to 5-month-old infants with torticollis differ from those of infants without torticollis and to determine the relationship between clinical characteristics and the Motor Optimality Score (MOS) in torticollis. METHODS Participants were 40 infants with torticollis and 40 infants developing typically without torticollis. The infants were evaluated with detailed general movement assessment. RESULTS There were significant differences in the MOS and subcategory scores for age-adequate movement repertoire and observed postural patterns between groups. Clinical characteristics were not related to the reduction in the MOS. CONCLUSIONS Infants with torticollis have differences in movements and postures at 3 to 5 months of age compared with controls. Strategies supporting the movement repertoire of infants with torticollis can be added to rehabilitation programs for infants with the lower MOS to optimize their motor development.
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Angane A, Anvekar A, Keshari P, Unnithan V. Neuroleptic-induced tardive dystonia in young patients suffering from psychosis. ARCHIVES OF MENTAL HEALTH 2022. [DOI: 10.4103/amh.amh_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Functional Symmetry Observation Scale, Version 2: Development and Content Validation Using a Modified Delphi Method. Pediatr Phys Ther 2022; 34:37-44. [PMID: 34958331 DOI: 10.1097/pep.0000000000000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the development of the Functional Symmetry Observation Scale (FSOS) Version 2 and its content validation. METHODS The FSOS Version 2 is an observational assessment that quantifies symmetry in spontaneous movement and posture in infants with congenital muscular torticollis, age birth to 18 months. Twenty expert pediatric physical therapists were identified through purposive sampling and invited to participate in a modified Delphi study. Survey data were collected on Qualtrics. Consensus was evaluated using median ratings and percent agreement on Likert Scale items. Thematic analysis was performed for open-ended question responses. RESULTS Thirteen experts completed Round 1 and 2 surveys. In Round 1, consensus was achieved on all but 1 item. The scale was modified based on received feedback. In Round 2, consensus was achieved on all items (median rating of 4, agreement at 85%-100%). CONCLUSIONS This study established the content validity of the FSOS Version 2.
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Kwon DR, Kim Y. Sternocleidomastoid size and upper trapezius muscle thickness in congenital torticollis patients: A retrospective observational study. Medicine (Baltimore) 2021; 100:e28466. [PMID: 34967390 PMCID: PMC8718228 DOI: 10.1097/md.0000000000028466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 12/10/2021] [Indexed: 01/05/2023] Open
Abstract
The purpose of this study was to investigate the upper trapezius muscle thickness (UTMT) in congenital muscular torticollis (CMT) patients and determine the correlation among sternocleidomastoid muscle thickness (SCMT), accessory nerve (AN) cross-sectional area (CSA), and UTMT in CMT.This retrospective study consisted of 2 participant groups: Group 1 (SCM mass CMT, n = 20) and Group 2 (Postural CMT, n = 22). For both groups, B-mode ultrasound was performed by a physiatrist to measure the SCMT and UTMT and calculate the CSA of the AN. The correlation among SCMT, CSA of the AN, and UTMT in both groups was evaluated.The between-group comparison revealed that Group 1 had significantly greater SCMT, UTMT, and CSA of the AN on the affected side than Group 2 (P < .05). The intragroup comparison between the affected and unaffected sides also revealed that, in Group 1, the SCMT, UTMT, and CSA of the AN were significantly higher on the affected side than on the unaffected side (P < .05), whereas no significant differences were observed in Group 2. In Group 1, a positive correlation (r = 0.55) was observed between the UTMT and CSA of the AN on the affected side, but not observed between the SCMT and CSA of the AN.The findings of the study indicate that sternocleidomastoid muscle size may impact the thickness of the upper trapezius muscle via the accessory nerve in patients with congenital torticollis.
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Affiliation(s)
- Dong Rak Kwon
- Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-Gu, Daegu, South Korea
| | - Yoontae Kim
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Chungcheongnam-do, South Korea
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Song H, Zhang X, Zou X. Chinese massage (Tuina) combline with paraffin therapy versus tuina or paraffin therapy alone for the treatment of congenital muscular torticollis: A protocol for systematic review and Bayesian network meta-analysis. Medicine (Baltimore) 2021; 100:e27648. [PMID: 34871237 PMCID: PMC8568347 DOI: 10.1097/md.0000000000027648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Current studies in patients with congenital muscular torticollis (CMT) have predominantly focused on the role of tuina or paraffin therapy alone. This systematic review with Bayesian network meta-analysis will be performed to sum up the existing evidence on the effects and safety of tuina plus paraffin therapy for CMT in infants and children. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes reporting guidelines will be followed to conduct this study. The electronic databases of PubMed, Cochrane Library, PsycINFO, EMBASE, the Chinese Scientific Journal Database, China National Knowledge Infrastructure, WanFang Data, Taiwan Electronic Periodical Services, and Web of Science will be searched from the inception to November 2021 using the following key terms: "Tuina," "traditional Chinese medicine massage," "paraffin," and "congenital muscular torticollis," for all relevant studies. We impose no language restrictions. We include reports on randomized controlled trials (RCTs) and quasi-RCTs of Tuina combline with paraffin therapy for the treatment of CMT in children and adolescents. We include studies that assessed effective rate, symmetry, improvements of range of motion, muscle length, and sternocleidomastoid tumor thickness, quality of life, and adverse events. The Cochrane Bias Risk Tool, which considers sequence generation, allocation concealment, and blinding and other aspects of bias, will be used to assess the risk of bias in studies. RESULTS A Bayesian network meta-analysis is an appropriate statistical method to compare all treatment options by statistically simulating the estimated results of a comprehensive trial, and to compare treatments by common and associated comparators. In addition, Bayesian network meta-analysis can produce ranking probabilities of treatments, which may contribute to clinicians' clinical decision-making. REGISTRATION NUMBER 10.17605/OSF.IO/K5EGN.
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Affiliation(s)
- Haikuo Song
- Department of Orthopedics and Traumatology of Integrated Traditional Chinese and Western Medicine, Tianjin Hospital, Tianjin, China
| | - Xuan Zhang
- College of Acupuncture, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiangfa Zou
- Department of Integrated Traditional Chinese and Western Medicine, the Second Hospital of Dalian Medical University, Liaoning, China
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Campbell SK. Functional movement assessment with the Test of Infant Motor Performance. J Perinatol 2021; 41:2385-2394. [PMID: 33883688 DOI: 10.1038/s41372-021-01060-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/17/2021] [Accepted: 03/30/2021] [Indexed: 02/02/2023]
Abstract
The purpose of this article is to review research on the Test of Infant Motor Performance, a functional assessment of movement capabilities with age standards for infants from 34 weeks postmenstrual age through 17 weeks post term (corrected age). The Test of Infant Motor Performance was normed on a U.S. population-based sample to support its use as a tool for diagnosing delayed motor development in early infancy. The test is one of the preferred methods for parents of babies in special care nurseries to learn about their infant's development. The test was used in a variety of clinical trials to document effects of early therapy and can be used as a short-term outcome measure for other interventions expected to impact functional motor performance.
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Affiliation(s)
- Suzann K Campbell
- Professor Emerita, University of Illinois at Chicago, and Partner, Infant Motor Performance Scales, LLC, Chicago, IL, USA.
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Vova JA, Green MM, Brandenburg JE, Davidson L, Paulson A, Deshpande S, Oleszek JL, Inanoglu D, McLaughlin MJ. A consensus statement on the use of botulinum toxin in pediatric patients. PM R 2021; 14:1116-1142. [PMID: 34558213 DOI: 10.1002/pmrj.12713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 08/12/2021] [Accepted: 09/10/2021] [Indexed: 11/10/2022]
Abstract
Botulinum toxin has been used in medicine for the past 30 years. However, there continues to be controversy about the appropriate uses and dosing, especially in the pediatric population. A panel of nine pediatric physiatrists from different regions and previous training programs in the United States were nominated based on institutional reputation and botulinum toxin (BoNT) experience. Based on a review of the current literature, the goal was to provide the rationale for recommendations on the administration of BoNT in the pediatric population. The goal was not only to review safety, dosing, and injection techniques but also to develop a consensus on the appropriate uses in the pediatric population. In addition to upper and lower limb spasticity, the consensus also provides recommendations for congenital muscular torticollis, cervical dystonia, sialorrhea, and brachial plexus palsies.
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Affiliation(s)
- Joshua A Vova
- Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael M Green
- University of Utah/Primary Children's Hospital, Salt Lake City, Utah, USA
| | | | - Loren Davidson
- University of California Davis, Sacramento, California, USA
| | - Andrea Paulson
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,Gillette Children's Specialty Healthcare, Minneapolis, Minnesota, USA
| | - Supreet Deshpande
- Gillette Children's Specialty Healthcare, Minneapolis, Minnesota, USA
| | | | - Didem Inanoglu
- Children's Health Specialty Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Park JI, Kee JH, Choi JY, Yang SS. Is Longstanding Congenital Muscular Torticollis Provoking Pelvic Malalignment Syndrome? CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8090735. [PMID: 34572167 PMCID: PMC8471492 DOI: 10.3390/children8090735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
It has been reported that congenital muscular torticollis (CMT) may result in secondary scoliosis over long-term follow-ups. However, there are few reports on whether CMT causes pelvic malalignment syndrome (PMS). This study aimed to investigate the relationship between CMT and PMS and to determine the factors associated with the development of PMS in children with longstanding CMT. Medical records of 130 children with CMT who had long-term follow-up were reviewed retrospectively. The chi-squared test and logistic regression analysis were used to determine which initial clinical parameters contributed to the development of PMS. Among 130 children with CMT, 51 (39.2%) developed PMS with or without compensatory scoliosis during long-term follow-up, indicating a high prevalence of PMS in children with a CMT history. Initial clinical symptoms such as a limited range of motion of the neck or the presence of a neck mass could not predict the development of PMS. Even if the clinical symptoms are mild, long-term follow-up of children with CMT is essential to screen for PMS.
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Chen SC, Yu J, Yuen SCS, Lam JCS, Suen LKP, Yeung WF. Massage therapy in infants and children under 5 years of age: protocol for an overview of systematic reviews. Syst Rev 2021; 10:127. [PMID: 33910623 PMCID: PMC8082656 DOI: 10.1186/s13643-021-01681-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 04/20/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Massage is a popularly used complementary and alternative therapy. Previous randomised controlled trials have examined the effects of massage on children, and several systematic reviews have been conducted to synthesise these data. This study aims to assess and summarise the current evidence from published systematic reviews of controlled clinical trials on the practice of paediatric massage, specifically in infants and children aged < 5 years. METHODS The online databases MEDLINE, Embase, Health Technology Assessment Database, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, China National Knowledge Infrastructure and Wanfang Data will be searched from the inception onwards for evidence of the treatment effects. We will include systematic reviews of randomised control trials evaluating the effects and safety of massage therapy in infants and children aged < 5 years. The primary outcomes will be any physical or psychological outcome, and adverse effects on children. Secondary outcomes will include any physical or psychological outcome on caregivers. Two reviewers will independently screen the articles for inclusion as per the eligibility criteria. They will extract information from the included studies and assess the methodological quality of the included studies. A table will be used to summarise of information of the included studies, which includes the basic information, method and findings. The methodological quality of the included systematic reviews will be assessed by A Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR 2). Extracted data from the included studies will be collected and presented using narrative approach. The pooled effect estimates for meta-analysed outcomes will be extracted when possible. If there is a discrepancy in results of two or more reviews on the same topic, then the causes of such discrepancy will be further explored. DISCUSSION This overview of systematic reviews will summarise the current evidence on massage, specifically for infants and children aged < 5 years. We will comprehensively present the positive effects and adverse effects of this intervention. Findings from this overview will be published in a peer-reviewed journal. SYSTEMATIC REVIEW REGISTRATION CRD42020186003 .
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Affiliation(s)
- Shu-Cheng Chen
- School of Nursing, Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Juan Yu
- Pediatric Tuina Health Care Clinic, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
| | - Sam Chun-Sum Yuen
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Jason Chun-Sing Lam
- School of Pharmacy, the Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Wing-Fai Yeung
- School of Nursing, Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China
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Pastor-Pons I, Hidalgo-García C, Lucha-López MO, Barrau-Lalmolda M, Rodes-Pastor I, Rodríguez-Fernández ÁL, Tricás-Moreno JM. Effectiveness of pediatric integrative manual therapy in cervical movement limitation in infants with positional plagiocephaly: a randomized controlled trial. Ital J Pediatr 2021; 47:41. [PMID: 33632268 PMCID: PMC7908758 DOI: 10.1186/s13052-021-00995-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Positional plagiocephaly (PP) is a cranial deformation frequent amongst children and consisting in a flattened and asymmetrical head shape. PP is associated with excessive time in supine and with congenital muscular torticollis (CMT). Few studies have evaluated the efficiency of a manual therapy approach in PP. The purpose of this parallel randomized controlled trial is to compare the effectiveness of adding a manual therapy approach to a caregiver education program focusing on active rotation range of motion (AROM) and neuromotor development in a PP pediatric sample. METHODS Thirty-four children with PP and less than 28 week-old were randomly distributed into two groups. AROM and neuromotor development with Alberta Infant Motor Scale (AIMS) were measured. The evaluation was performed by an examiner, blinded to the randomization of the subjects. A pediatric integrative manual therapy (PIMT) group received 10-sessions involving manual therapy and a caregiver education program. Manual therapy was addressed to the upper cervical spine to mobilize the occiput, atlas and axis. The caregiver educational program consisted in exercises to reduce the positional preference and to stimulate motor development. The control group received the caregiver education program exclusively. To compare intervention effectiveness across the groups, improvement indexes of AROM and AIMS were calculated using the difference of the final measurement values minus the baseline measurement values. If the distribution was normal, the improvement indexes were compared using the Student t-test for independent samples; if not, the Mann-Whitney U test was used. The effect size of the interventions was calculated using Cohen's d. RESULTS All randomized subjects were analysed. After the intervention, the PIMT group showed a significantly higher increase in rotation (29.68 ± 18.41°) than the control group (6.13 ± 17.69°) (p = 0.001). Both groups improved the neuromotor development but no statistically significant differences were found. No harm was reported during the study. CONCLUSION The PIMT intervention program was more effective in increasing AROM than using only a caregiver education program. The study has been retrospectively registered at clinicaltrials.gov, with identification number NCT03659032 . Registration date: September 1, 2018.
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Affiliation(s)
- Iñaki Pastor-Pons
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009, Zaragoza, Spain
- Instituto de Terapias Integrativas, San Miguel, 16, 50001, Zaragoza, Spain
| | - César Hidalgo-García
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009, Zaragoza, Spain.
| | - María Orosia Lucha-López
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009, Zaragoza, Spain
| | | | - Iñaki Rodes-Pastor
- Instituto de Terapias Integrativas, San Miguel, 16, 50001, Zaragoza, Spain
| | - Ángel Luis Rodríguez-Fernández
- Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo CEU, Urbanización Montepríncipe, 28925, Alcorcón, Madrid, Spain
| | - José Miguel Tricás-Moreno
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009, Zaragoza, Spain
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Genna CW, Saperstein Y, Siegel SA, Laine AF, Elad D. Quantitative imaging of tongue kinematics during infant feeding and adult swallowing reveals highly conserved patterns. Physiol Rep 2021; 9:e14685. [PMID: 33547883 PMCID: PMC7866619 DOI: 10.14814/phy2.14685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/18/2022] Open
Abstract
Tongue motility is an essential physiological component of human feeding from infancy through adulthood. At present, it is a challenge to distinguish among the many pathologies of swallowing due to the absence of quantitative tools. We objectively quantified tongue kinematics from ultrasound imaging during infant and adult feeding. The functional advantage of this method is presented in several subjects with swallowing difficulties. We demonstrated for the first time the differences in tongue kinematics during breast- and bottle-feeding, showing the arrhythmic sucking pattern during bottle-feeding as compared with breastfeeding in the same infant with torticollis. The method clearly displayed the improvement of tongue motility after frenotomy in infants with either tongue-tie or restrictive labial frenulum. The analysis also revealed the absence of posterior tongue peristalsis required for safe swallowing in an infant with dysphagia. We also analyzed for the first time the tongue kinematics in an adult during water bolus swallowing demonstrating tongue peristaltic-like movements in both anterior and posterior segments. First, the anterior segment undulates to close off the oral cavity and the posterior segment held the bolus, and then, the posterior tongue propelled the bolus to the pharynx. The present methodology of quantitative imaging revealed highly conserved patterns of tongue kinematics that can differentiate between swallowing pathologies and evaluate treatment interventions. The method is novel and objective and has the potential to advance knowledge about the normal swallowing and management of feeding disorders.
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Affiliation(s)
| | - Yiela Saperstein
- Department of Biomedical EngineeringColumbia UniversityNew YorkNYUSA
| | - Scott A. Siegel
- School of Medicine/School of Dental MedicineStony Brook UniversitySuffolk CountyNYUSA
| | - Andrew F. Laine
- Department of Biomedical EngineeringColumbia UniversityNew YorkNYUSA
| | - David Elad
- Department of Biomedical EngineeringColumbia UniversityNew YorkNYUSA
- Department of Biomedical EngineeringTel‐Aviv UniversityTel‐AvivIsrael
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Kim MW, Kim DY, Lee DW, Ryoo DH, Kim J, Jang DH. Concurrence of Congenital Muscular Torticollis and Congenital Torticollis Due to Other Anomalies: Two Case Reports. Front Pediatr 2021; 9:709616. [PMID: 34778123 PMCID: PMC8578520 DOI: 10.3389/fped.2021.709616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Congenital muscular torticollis (CMT) is the most common cause of torticollis in infants; other causes, including osseous, ocular, and central nervous system torticollis can easily be overlooked. We report two rare cases of CMT with concurrent osseous or ocular torticollis. Case 1: A 1-month-old female infant with a right neck mass and right-tilting head posture was referred. Neck ultrasonography showed diffuse hypertrophy and hyperechoic findings on the right sternocleidomastoid (SCM) muscle, which was consistent with right CMT. A clavicle X-ray imaging was conducted to identify an associated fracture due to birth trauma on the same day and a suspected congenital vertebral anomaly was coincidentally found. Subsequent three-dimensional computed tomography of the cervical spine showed a T1 hemivertebra causing the right-tilting head. The patient was diagnosed with the concurrent manifestation of CMT and congenital osseous torticollis. Case 2: A 3-month-old male infant with a 20° head tilt to the right with a limited cervical range of motion was referred. Neck ultrasonography showed a fibromatosis colli in the right SCM, suggesting CMT. He proceeded to physical therapy for seven months; however, there was little clinical improvement in his head and neck posture. The patient underwent an additional ophthalmologic examination and orbital magnetic resonance imaging (MRI) at 10 months of age. The result showed congenital agenesis of the left fourth cranial nerve with hypoplasia of the superior oblique muscle causing the right-tilting of the head. Ultimately, the boy was diagnosed with a concurrent manifestation of CMT and congenital ocular torticollis. Conclusion: Unless careful examinations are conducted, congenital vertebral anomalies and congenital agenesis of the fourth cranial nerve can go unnoticed in the present two cases. If a patient with CMT displays unusual features or does not respond to physical therapy, clinicians should consider not only a differential diagnosis but also concurrence with other causes of congenital torticollis.
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Affiliation(s)
- Min-Wook Kim
- Department of Rehabilitation Medicine, College of Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Da-Ye Kim
- Department of Rehabilitation Medicine, College of Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Dong-Woo Lee
- Department of Rehabilitation Medicine, College of Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Da-Hye Ryoo
- Department of Rehabilitation Medicine, College of Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jaewon Kim
- Department of Rehabilitation Medicine, College of Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Dae-Hyun Jang
- Department of Rehabilitation Medicine, College of Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
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Khorrami-Nejad M, Akbari M, Kangari H, Akbarzadeh Baghban A, Ranjbar Pazouki M. Ocular abnormal head posture: A literature review. J Curr Ophthalmol 2021; 33:379-387. [PMID: 35128182 PMCID: PMC8772496 DOI: 10.4103/joco.joco_114_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 11/04/2022] Open
Abstract
Purpose: Methods: Results: Conclusion:
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Congenital Osseous Torticollis that Mimics Congenital Muscular Torticollis: A Retrospective Observational Study. CHILDREN-BASEL 2020; 7:children7110227. [PMID: 33202872 PMCID: PMC7696718 DOI: 10.3390/children7110227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/02/2022]
Abstract
It may be difficult to diagnose congenital osseous torticollis based on physical examinations or plain X-rays, especially when children have no other accompanying congenital defects. This study reports the children with torticollis caused by the vertebral anomaly with the symptom of abnormal head and neck posture only. We retrospectively reviewed the records of 1015 patients diagnosed with congenital torticollis in a single tertiary hospital (Incheon St. Mary’s Hospital, Korea) who were referred from a primary local clinic. We included those with deficits in passive range of motion (PROM) of neck. Ultrasonography of the sternocleidomastoid (SCM) muscles, ophthalmologic and neurologic examinations, and cervical X-rays were performed for all patients. If bony malalignment was suspected from X-ray, three-dimensional volume-rendered computed tomography (3D-CT) was performed. Ten patients were diagnosed with osseous torticollis with no defect other than bony anomalies. Although X-ray images were acquired for all patients, vertebral anomalies were definitely confirmed in three cases (30.0%) only, and the others (70.0%) were confirmed by CT. The most common type of vertebral anomaly was single-level fusion. Identifying congenital vertebral anomalies is challenging especially when the degree of invasion is only one level. Although abnormal findings on X-rays may be subtle, a careful examination must be performed to avoid misdiagnosis.
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The Effectiveness and Safety of Botulinum Toxin Injections for the Treatment of Congenital Muscular Torticollis. J Craniofac Surg 2020; 31:2160-2166. [PMID: 33136847 DOI: 10.1097/scs.0000000000006652] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Botulinum toxin have been used to treat congenital muscular torticollis for the last 25 years; however, few studies have been published with only limited cases and short-term follow-up. The aim of the present study is to systematically review the effectiveness and safety of botulinum toxin injections for congenital muscular torticollis by analyzing these relevant literatures. METHODS The authors searched PubMed, Web of Science, EMBASE, Cochrane Library, China Biology Medicine, for all articles about botulinum toxin injections for the congenital muscular torticollis. The MINORS evaluation tool was adopted to evaluate the quality of these studies. Meta-analysis calculations are made by R software 3.6.2. RESULTS This study search involved strict inclusion criteria and targeted data collection. Ten studies were included, with a total of 411 patients, comprising 1 non-randomized experimental study and 9 cases or case series. The results of our meta-analysis of single rate showed that the overall effective rate of botulinum toxin for congenital muscular torticollis was 84% (95% confidence interval [CI] 67%-96%). After botulinum toxin treatment, the conversion rate to surgery was 9% (95% CI 4%-22%), and the adverse reaction rate was 1% (95% CI 0%-3%). The most common adverse reactions among these included studies involve injection site erythema and transient dysphagia. CONCLUSION Current evidence shows that botulinum toxin injections for the treatment of congenital muscular torticollis is safe and effective, with few serious adverse reactions. Further well-designed, larger randomized trials are warranted.
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Seager A, Meldrum D, Conroy R, French HP. Congenital muscular torticollis: the reliability of visual estimation in the assessment of cervical spine active rotation and head tilt by physiotherapists and the impact of clinical experience. Eur J Pediatr 2020; 179:1823-1832. [PMID: 32468158 DOI: 10.1007/s00431-020-03691-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 11/28/2022]
Abstract
There is a lack of reliable and valid measurement tools to assess neck function in infants with congenital muscular torticollis, and most physiotherapists use visual estimation, which has not been adequately tested for reliability in this population. We examined the reliability of visual estimation of head tilt and active neck rotation in the upright position, on infants with congenital muscular torticollis by physiotherapists. We recruited 31 infants and 26 physiotherapists. Therapists rated videos of infants' head position in the frontal plane (tilt) and transverse plane (active rotation) using visual estimation, on two occasions at least one week apart. Overall, inter-rater reliability was good (mean ICC, 0.68 ± 0.20; mean SEM, 5.1° ± 2.1°). Rotation videos had better reliability (mean ICC, 0.79 ± 0.14) than head tilt videos (mean ICC, 0.58 ± 0.20). Intra-rater reliability was excellent (mean ICC, 0.85 ± 0.08). Both head tilt and rotation had excellent reliability (mean ICC, 0.84 ± 0.08 for head tilt and 0.85 ± 0.09 for rotation). There was no correlation between intra-rater reliability and clinical experience.Conclusion Visual estimation had excellent intra-rater reliability in the assessment of neck active rotation and head tilt on infants with congenital muscular torticollis. Visual estimation had acceptable inter-rater reliability in the assessment of neck active rotation but not of head tilt. There was a wide variation in reliability with no correlation between reliability and clinical experience. Assessment tools for head tilt that are more psychometrically robust should be developed. What is Known: • A thorough assessment of infants presenting with torticollis is essential, using assessment tools with robust psychometric properties • Visual estimation is the most commonly used method of assessment of neck function in infants with torticollis What is New: • Visual estimation had excellent intra-rater reliability in the assessment of neck active rotation and head tilt in the upright position in videos of infants and acceptable inter-rater reliability in the assessment of rotation but not of head tilt • Physiotherapists' clinical experience had minimal relationship with reliability.
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Affiliation(s)
- Anthea Seager
- Department of Physiotherapy, Children's Health Ireland at Temple Street, Dublin, 1, Ireland.
| | - Dara Meldrum
- School of Medicine, Trinity College, Dublin University, Dublin 2, Ireland
| | - Ronan Conroy
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland
| | - Helen P French
- School of Physiotherapy, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland
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Experiences of Parents of Infants Diagnosed With Mild or Severe Grades of Congenital Muscular Torticollis. Pediatr Phys Ther 2020; 32:322-329. [PMID: 32991556 DOI: 10.1097/pep.0000000000000738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The primary purpose of this study was to describe the experiences of parents of infants diagnosed with congenital muscular torticollis (CMT). A secondary purpose was to compare the experiences of parents of infants with mild grades versus severe grades of involvement based on the CMT severity classification system. METHODS Through semistructured interviews, a qualitative phenomenological approach of inquiry was used to investigate the lived experiences of 12 parents. RESULTS Eight themes common to both groups of parents were identified. Findings indicated having an infant with CMT has a significant effect on the parents and other caregivers. Two themes were unique to parents of the infants with severe CMT. CONCLUSIONS Parents are faced with a diagnosis that requires regular therapy visits and a challenging home program. A multimodal approach by clinicians for teaching and supporting parents during the episode of care may best address their unique challenges and stresses.
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Abstract
PURPOSE To determine how physical therapy utilization varies with Congenital Muscular Torticollis (CMT) Severity Grading Scale, considering episode of care and clinical practice guidelines. METHODS A 3-year retrospective medical record review was conducted. Data were collected for 81 infants receiving physical therapy for CMT. Sample and service characteristics are described; 46 complete records (infants 6 months or younger) were analyzed to determine how physical therapy utilization varied across severity grades. RESULTS AND CONCLUSIONS Of the 46 infants with complete care episodes, half had fully resolved all asymmetries. Units billed, episode duration, and total visits each increased across CMT severity grades 1 to 3. Cervical rotation restrictions correlated with total units billed, indicating a positive relationship between CMT severity and service utilization. WHAT THIS ADDS TO THE EVIDENCE This study supports that as CMT severity increases, physical therapy utilization increases for grades 1 to 3 of the 2018 CMT Severity Grading Scale.
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A Survey of Pediatric Competencies in Entry-Level Physical Therapy Programs in Australia. Pediatr Phys Ther 2020; 32:356-365. [PMID: 32925813 DOI: 10.1097/pep.0000000000000730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe perspectives of pediatric physical therapy clinical facilitators on contemporary curricula for Australian entry-level physical therapy programs. METHODS Physical therapy clinical facilitators completed an online survey based on the Academy of Pediatric Physical Therapy of the APTA essential competencies. RESULTS Conditions including cerebral palsy, cystic fibrosis, and prematurity were highly rated by most participants to include in an entry-level program. Exercise prescription, goal-directed training, and group-based physical therapy were the highest rated interventions. Outcome measures considered important to include were the Alberta Infant Motor Scale and Goal Attainment Scale. Students should demonstrate knowledge and skills using relevant frameworks and have practical opportunities to interact with children. CONCLUSION Pediatric clinical facilitators perceived that theoretical knowledge on frameworks, human development, movement skills, pediatric conditions, exercise prescription, and outcome measurement as well as face-to-face experiences with children are important to include in Australian entry-level physical therapy programs.
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Xiao Y, Chi Z, Yuan F, Zhu D, Ouyang X, Xu W, Li J, Luo Z, Chen R, Jiao L. Effectiveness and safety of massage in the treatment of the congenital muscular torticollis: A systematic review and meta-analysis protocol. Medicine (Baltimore) 2020; 99:e21879. [PMID: 32871916 PMCID: PMC7458238 DOI: 10.1097/md.0000000000021879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Massage has been widely used in the treatment of muscular torticollis in children, but there is no objective and systematic evaluation of the efficacy of various literature, and the efficacy of massage in the treatment of congenital muscular torticollis (CMT) is not clear. The purpose of this study is to evaluate the clinical efficacy and safety of massage in the treatment of muscular torticollis in children. METHODS Relevant randomized controlled trials (RCTs) will be searched from the databases of PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database from their inception to May 2020. Two reviewers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The RevMan V.5.3 will be used for meta-analysis. RESULTS This study will provide an assessment of the current state of Chinese massage therapy for the congenital muscular torticollis, aiming to show the efficacy and safety of massage treatment. CONCLUSION This study will provide evidence to judge whether massage is an effective intervention for the third lumbar vertebrae transverse process syndrome. INPLASY REGISTRATION NUMBER INPLASY202070086.
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Affiliation(s)
- Yuanyi Xiao
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Zhenhai Chi
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Fuqiang Yuan
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Daocheng Zhu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Xilin Ouyang
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Wei Xu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jun Li
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Zhaona Luo
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Rixin Chen
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Lin Jiao
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Becker M, Strunk K, Buschhaus N, Bühn S, Pieper D. Methodological Quality of Physical Therapy Guidelines and Their Suitability for Adaptation: A Scoping Review. Phys Ther 2020; 100:1296-1306. [PMID: 32315432 DOI: 10.1093/ptj/pzaa075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/26/2019] [Accepted: 02/11/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Clinical practice guidelines (CPGs) can be characterized to the extent that they specifically address physical therapists and mainly contain recommendations for physical therapist interventions. The primary aim of this study was to identify existing physical therapy CPGs regardless of medical condition, with a secondary aim of assessing their methodological quality to determine whether they are potentially suitable for adaptation. METHODS Systematic searches of the Medline and Physiotherapy Evidence Database were performed (August 2019), and the websites of World Confederation for Physical Therapy members were screened (September 2019). Only CPGs published in German or English were included. Two independent reviewers screened records according to previously defined inclusion criteria. Information was extracted regarding country of origin, year of publication, and clinical subject area addressed. Four independent reviewers assessed the quality of physical therapy CPGs using the Appraisal of Guidelines Research and Evaluation instrument. A descriptive data analysis was performed. RESULTS Thirty-five CPGs met the inclusion criteria; 46% (16/35) of the included CPGs were from the United States, and 31% (11/35) were from the Netherlands. Assessment using the Appraisal of Guidelines Research and Evaluation tool resulted in the following domain scores, presented as median percentage (interquartile range): domain 1 (scope and purpose), 76 (63-92); domain 2 (stakeholder involvement), 63 (55-76); domain 3 (rigor of development), 67 (53-75); domain 4 (clarity of presentation), 74 (67-77); domain 5 (applicability), 44 (30-57); and domain 6 (editorial independence), 52 (35-66). CONCLUSIONS In general, the methodological quality of the included CPGs was moderate to good. Possibilities of adapting recommendations from existing CPGs should be considered with the development of new physical therapy CPGs. IMPACT STATEMENT This study can raise awareness of existing physical therapy CPGs and can support their application by physical therapists. Further, the study can support decisions on adapting existing CPGs with the planning of new physical therapy CPGs.
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Affiliation(s)
- Monika Becker
- Department Evidence-based Health Services Research, Faculty of Health, Department of Medicine, Institute for Research in Operative Medicine, Witten / Herdecke University, Ostmerheimer Str. 200, Building 38, 51109 Cologne, Germany
| | - Katharina Strunk
- Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany, and Department Evidence-based Health Services Research, Faculty of Health, Department of Medicine, Institute for Research in Operative Medicine
| | - Niels Buschhaus
- Department Evidence-based Health Services Research, Faculty of Health, Department of Medicine, Institute for Research in Operative Medicine
| | - Stefanie Bühn
- Department Evidence-based Health Services Research, Faculty of Health, Department of Medicine, Institute for Research in Operative Medicine
| | - Dawid Pieper
- Department Evidence-based Health Services Research, Faculty of Health, Department of Medicine, Institute for Research in Operative Medicine
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Hwang J, Khil EK, Jung SJ, Choi JA. Correlations between the Clinical and Ultrasonographic Parameters of Congenital Muscular Torticollis without a Sternocleidomastoid Mass. Korean J Radiol 2020; 21:1374-1382. [PMID: 32729272 PMCID: PMC7689138 DOI: 10.3348/kjr.2019.0893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/10/2020] [Accepted: 04/16/2020] [Indexed: 11/16/2022] Open
Abstract
Objective To determine whether ultrasonography at initial presentation can help assess the clinical severity of congenital muscular torticollis (CMT) in infants without a sternocleidomastoid muscle (SCM) mass. Materials and Methods This retrospective study included 71 infants aged less than 12 months (4.1 ± 2.3 months) with non-mass CMT. The clinical severity was divided into three grades (groups 1–3) based on the degree of lateral head bending or cervical rotation. The difference (SCM-D) and ratio (SCM-R) between the maximal thickness of the affected and non-affected SCMs were obtained using transverse and longitudinal ultrasonography. The sonographic echotexture and echogenicity of the involved SCM were reviewed. Results A significant difference was observed in the SCM-D (0.42 ± 0.30 mm in group 1; 0.74 ± 0.50 mm in group 2; 1.14 ± 0.85 mm in group 3; p = 0.002) and SCM-R (1.069 ± 0.067 in group 1; 1.129 ± 0.087 in group 2; 1.204 ± 0.150 in group 3; p = 0.001) among the groups when measured along the longitudinal but not along the transverse ultrasonography plane. The areas under the curves of the SCM-R and SCM-D measured by longitudinal ultrasonography were 0.731 (p < 0.001) and 0.731 (p < 0.001) for group 1 versus groups 2–3. The proportions of heterogeneous echotexture or hyperechogenicity in the involved SCM did not differ significantly among the three clinical groups (all p > 0.05). Conclusion Ultrasonography can aid in assessing the clinical severity of CMT in infants without an SCM mass at the time of initial diagnosis. The SCM-R and SCM-D helped grade the clinical severity when obtained by longitudinal scan.
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Affiliation(s)
- Jisun Hwang
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Eun Kyung Khil
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
| | - Soo Jin Jung
- Department of Rehabilitation Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Jung Ah Choi
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
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