Correlations and Predictors of the Duration of Physical Therapy in Infants Diagnosed With Congenital Muscular Torticollis

Abstract

Congenital muscular torticollis (CMT) is the most common musculoskeletal disorder in infancy. The aim of this study was to determine the long-term outcomes of different subtypes of CMT using ultrasonographic (US) diagnostic studies, which could affect the length of physical therapy (PT) in infants with CMT and elicit an early referral. We performed a retrospective analysis of 76 CMT infants who were referred for US investigation and PT between January 2014 and May 2017. The PT duration was 149 ± 72 days, and most infants received PT 2 times/week. The depth ratio and difference between the affected and non-affected bilateral sternocleidomastoid muscle (SCM), passive neck rotation, and lateral flexion were significantly improved after PT. The duration of PT and the number of PT sessions were found to be correlated with initial passive neck rotation (p ＜ 0.001, p ＜ 0.001) and lateral flexion (p = 0.031, p = 0.027). According to linear regression analysis, the initial passive neck rotation was the strongest predictive factor of the duration of PT (p = 0.001) and the number of PT sessions (p ＜ 0.001). Muscular torticollis can be effectively treated by traditional PT. A greater limitation in passive neck rotation requires a longer duration of PT, and attention should be paid to this issue during monitoring of the development of infants with postural torticollis.