The efficacy of passive stretch exercises in congenital muscular torticollis

Abstract

Conservative treatment is a successful treatment approach in congenital muscular torticollis, a disease which is characterized with the tilt of head and neck and rotational deformity. In this study the relationship between the age and efficacy of conservative treatment was investigated reviewing retrospectively the data of 92 cases followed up with the diagnosis of congenital muscular torticollis between 2000 and 2007. The cases were divided into two groups according to the age at presentation: early period (under 1 year of age) and late period (older than 1 year of age). The two groups were compared with respect to demographic and clinical features and response to treatment. Of the 92 cases, 68 (63%) were under 1 year of age (early period) and 24 (37%) were older than 1 year of age (late period) at presentation. All the cases had limitation of neck motion and tilt of sternocleidomastoid muscle on the involved side. Facial asymmetry was present in 24 cases (35%) in the early period group and 24 cases (100%) in the late period group. Plagiocephaly was present in 18 cases (26%) in the early period group and 19 cases (79%) in the late period group. All the patients in early period group gave a complete response to treatment during follow-up. Surgical intervention was performed in 8 cases (34%) older than 1 year of age. We believe that neck motion returns to normal range in the short-term, the mass in the sternocleidomastoid muscle resolves without leading to fibrosis and the development of facial asymmetry is prevented in cases diagnosed and started manual stretching exercises at an early age.