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Background Information 2 CMT Tight sternocleido-mastoid (SCM) muscle

In infants with congenital muscular torticollis (CMT) does aggressive frequency/duration of physical t herapy impact rate of returning symmetrical cervical range of motion compared to traditional therapy treatment?. Background Information 2 CMT Tight sternocleido-mastoid (SCM) muscle

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Background Information 2 CMT Tight sternocleido-mastoid (SCM) muscle

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  1. In infants with congenital muscular torticollis (CMT) does aggressive frequency/duration of physical therapy impact rate of returning symmetrical cervical range of motion compared to traditional therapy treatment? Background Information2 CMT Tight sternocleido-mastoid (SCM) muscle Child’s head side-bends ipsilaterally and rotates contralaterally 3rd most common congenital deformation Differential Diagnosis: Postural Torticollis Traditional Therapy Defined4 Ipsilateral SCM stretching Active positioning Handling to stimulate symmetry Contralateral SCM strengthening Current Literature The frequency and duration of treatment for a tight SCM has very rarely been the sole purpose in any study. However, the literature suggests other factors play a greater role in returning symmetrical cervical ROM and have any effect on frequency and duration.1,2,3,4,5 Clinical Relevance • Invasive treatment is more likely with increased treatment and residual ROM deficits1 • PT is main therapeutic procedure that can eliminate necessity of surgical procedure2 • Age is best predictor of outcome3 • Children referred to PT before 1 year of age have better outcomes3 Pilot Study 4 • N=20 • Ages 2.5wks – 4.9mos • Limited rotational ROM • Parent group vs. PT group Prospective Study 5 • N=45 • Ages 15-120 days • Intensive home exercise program • Parental Education References • Christensen C, Landsettle A, Antoszewski S, Ballard B, Carey H, Pax Lowes L. Conservative Management of Congenital Muscular Torticollis: An Evidence-Based Algorithm and Preliminary Treatment Parameter Recommendations. Physical & Occupational Therapy In Pediatrics [serial online]. November 2013;33(4):453-466. Available from: Academic Search Premier, Ipswich, MA. Accessed November 25, 2013. • Petronic I, Brdar R, Cirovic D, et al. Congenital muscular torticollis in children: distribution, treatment duration and outcome. EUR J PHYS REHABIL MED. 2010;45(2):153–158. • Emery C. The determinants of treatment duration for congenital muscular torticollis. Physical therapy. 1994;74(10):921–9. Available at: http://www.ncbi.nlm.nih.gov/pubmed/8090843. • Ohman A, Nilsson S, Beckung E. Stretching treatment for infants with congenital muscular torticollis: physiotherapist or parents? A randomized pilot study. PM & R : the journal of injury, function, and rehabilitation. 2010;2(12):1073–9. doi:10.1016/j.pmrj.2010.08.008. • Celayir A. Congenital muscular torticollis: Early and intensive treatment is critical. A prospective study. Pediatrics International [serial online]. October 2000;42(5):504-507. Available from: Academic Search Premier, Ipswich, MA. Accessed November 25, 2013. http://www.netterimages.com/image/7603.htm http://www.torticolliskids.org/ Megan Davis and Bret Ramsey

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