The effectiveness of stretching for infants with congenital muscular torticollis

Abstract

Introduction: Congenital muscular torticollis (CMT) is a neck deformity that involves unilateral shortening of the sternocleidomastoid (SCM). Conservative physiotherapy management of CMT is primarily focused on stretching the affected SCM. However, there is limited research evidence on the use of stretching to improve the extensibility of SCM in infants with CMT.

Aim: To investigate the effectiveness of stretching for infants with CMT.

Method: A systematic search of AMED, CINAHL, MEDLINE, EMBASE, Physiotherapy Evidence Database (PEDro) and Cochrane Library was conducted during the period 2011–2018.

Results: Seven articles that met eligibility criteria were reviewed out of a total number of 415 articles that were screened; two articles were randomised control trials and five were cohort studies. The studies typically reported statistically significant benefits of stretching for the restoration of cervical range of movement and SCM thickness (p < 0.05). Appraisal of the studies revealed varied quality.

Conclusion: The results suggest that stretching is an effective treatment intervention for the management of infants with CMT and early physiotherapy referral can lead to decreased treatment duration. However, due to a variation in study quality; additional high-quality research is needed to help formulate more robust conclusions.

Keywords:

• Congenital muscular torticollis;
• CMT
• stretching
• conservative management
• physiotherapy

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Bradley Poole

Bradley Poole was a student on the MSc (pre-registration) physiotherapy at the School of Health Sciences, University of East Anglia, Norwich, UK. He carried out this literature review as part of his research dissertation project. He is currently practicing as a musculoskeletal physiotherapist at Cossham Hospital, Bristol, UK.

Swati Kale

Swati Kale is a lecturer in physiotherapy at the School of Health Sciences, University of East Anglia, Norwich, UK. Her research interests include interventions used in paediatric physiotherapy, determining predictive validity of processes used for selection of undergraduate students in physiotherapy, social inequities in health and use of technology in health education.