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Conservative management of congenital muscular torticollis: an evidence-based algorithm and preliminary treatment parameter recommendations |
Christensen C, Landsettle A, Antoszewski S, Ballard BB, Carey H, Pax Lowes L |
Physical & Occupational Therapy in Pediatrics 2013;33(4):453-466 |
systematic review |
PURPOSE: To present an algorithm with accompanying treatment parameters for the management of congenital muscular torticollis (CMT) based on the best available literature. METHODS: A systematic search of PubMed, Medline, CINAHL, and Cochrane databases was conducted to identify evidence to guide the conservative management of CMT. RESULTS: An evidence-based algorithm was created based on three prognostic factors that influence treatment duration and outcome, including a sternocleidomastoid fibrotic mass, passive range of motion rotation deficit, and age at initiation of treatment. Preliminary treatment parameter recommendations for clinic and home programming accompany the algorithm. CONCLUSION: Use of the proposed evidence-based algorithm with accompanying preliminary treatment parameter recommendations may improve consistency of care and outcomes for infants with CMT. While a higher level of evidence supports the three prognostic factors utilized in the algorithm, research gaps continue to exist with regards to treatment parameters.
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