Development of the Last Mass Diameter Prediction Model for Congenital Muscular Torticollis Infants Provided Physical Therapy

물리치료를 받은 선천성 근성 사경 환아의 최종 종괴 지름 예측 모형 개발

  • Lee, In-Hee (Dept. of Medical Informatics, School of Medicine, Keimyeung University) ;
  • Shin, A-Mi (Dept. of Medical Informatics, School of Medicine, Keimyeung University) ;
  • Lee, Gyeong-Ho (Dept. of Medical Informatics, School of Medicine, Keimyeung University) ;
  • Park, Hee-Joon (Dept. of Medical Informatics, School of Medicine, Keimyeung University) ;
  • Kim, Yoon-Nyun (Dept. of Medical Informatics, School of Medicine, Keimyeung University)
  • 이인희 (계명대학교 의과대학 의료정보학교실) ;
  • 신아미 (계명대학교 의과대학 의료정보학교실) ;
  • 이경호 (계명대학교 의과대학 의료정보학교실) ;
  • 박희준 (계명대학교 의과대학 의료정보학교실) ;
  • 김윤년 (계명대학교 의과대학 의료정보학교실)
  • Received : 2009.03.20
  • Accepted : 2009.05.29
  • Published : 2009.06.25

Abstract

Purpose: The pathophysiology of congenital muscular torticollis (CMT) is that the sternoclavicularmastoid (SCM) is shortened on the involved side by fibrosis, leading to an ipsilateral tilt and contralateral rotation of the face and chin. The aim of this study was to examine the effect of physical therapy and develop a mass diameter prediction model for infants with CMT. Methods: Fifty six patients were diagnosed with CMT between April 2003 and December 2008. Infants with neurological complications, and spasmodic and ocular torticollis were excluded. Physical therapy was applied to those masses in the SCM muscles of those infants after checking their physical findings and the diameter of the mass with ultrasonography. Their physical findings and mass diameter was reevaluated when their neck tilt was under $5^{\circ}$. Results: The mean age when physical therapy was started was 35 days. After a mean 90 days of treatment, the subjects showed improvement in the neck tilt. Subjects whose neck tilted above $15^{\circ}$ showed significant improvement in neck tilt decreased their mass diameter (p<0.01). Facial symmetric infants showed a shorter recovery duration than the facial asymmetric infants (p<0.05). A mass decreasing model based on the diameter of the mass, facial symmetry or not and the physical therapy start day after birth was developed by linear regression. Conclusion: Physical therapy is an effective treatment for CMT. The change in the diameter of the mass on the SCM muscles after treatment can be predicted.

Keywords

References

  1. Netter FH. The CIBA Collection of Medical Illustrations. Vol 8. Musculoskelectal system. In: Part II. Developmental Disorders, Tumors, Rheumatic diseases and Joint Replacement. Summit, NJ, Ciba‐Geigy Co, 1990.
  2. Blinder H, Eng GD, Gaiser JF et al. Congenital muscular torticollis: Results of conservative management with longterm follow-up in 85 cases. Arch Phys Med Rehabil. 1987;68(4):222-5.
  3. Hummer CD, MacEwen GD. The coexistence of torticollis and congenital dysplasia of the hip. J Bone Joint Surg Am. 1972;54(6):1255-6.
  4. Park TK, Kim JY, Park RJ et al. Effect of myofascial release therapy on newborn and infants with congenital torticollis. The Journal of Korea Society of Physical Therapy. 2006;18(5):1-11. https://doi.org/10.1589/jpts.18.1
  5. Cheng JC, Tang SP, Chen TM et al. The clinical presentation and outcome of treatment of congenital muscular torticollis in infants -A study of 1,086 cases. J Pediatr Surg. 2000;35(7):1091-6. https://doi.org/10.1053/jpsu.2000.7833
  6. Demirbilek S, Atayurt HF. Congenital muscular torticollis and sternomastoid tumor: Results of nonoperative treatment. J Pediatr Surg. 1999;34(4):549-51. https://doi.org/10.1016/S0022-3468(99)90070-2
  7. Rahlin M. TAMO therapy as a major component of physical therapy intervention for an infant with congenital muscular torticollis: A case report. Pediatr Phys Ther. 2005;17(3):209-18. https://doi.org/10.1097/01.pep.0000179176.20035.f0
  8. Taylor JL, Norton ES. Developmental muscular torticollis: Outcomes in young children treated by physical therapy. Pediatr Phys Ther. 1997;9(4):173-8.
  9. Collins A, Jankovic J. Botulinum toxin injection for congenital muscular torticollis presenting in children and adults. Neurology. 2006;67(6):1083-5. https://doi.org/10.1212/01.wnl.0000237336.65596.21
  10. Oleszek JL, Chang N, Apkon SD et al. Botulinum toxin type A in the treatment of children with congenital muscular torticollis. Am J Phys Med Rehabil. 2005;84(10):813-6. https://doi.org/10.1097/01.phm.0000179516.45373.c4
  11. Kim MO, Kim SJ. Results of the conservative management in congenital muscular torticollis. J Korean Acad Rehabil Med. 1992;16(1):42-50.
  12. Kim SJ, Park EM, Choi WK et al. The correlation between outcome and ultrasonic findings in congenital muscular torticollis. J Korean Acad Rehabil Med. 2001;25(4):601-8.
  13. Jun JE, Rhu HK, Shim JW et al. Clinical features of congenital muscular torticollis. Korean J pediatr. 2007;50(3):241-7. https://doi.org/10.3345/kjp.2007.50.3.241
  14. Lee YT, Chang JS, Park BM. A clinical study of congenital muscular torticollis. J Korean Orthop assoc. 1986;21(3):423-32.
  15. Park JH, Kang SY, Kim JK. Rehabilitation of torticollis in children. J Korean Acad Rehabil Med. 1998;22(2):261-8.
  16. Lee IH. The effect of manual stretching and positioning and developmental treatment in congenital muscular torticollis: randomized controlled trial. Journal of the Korean Academy of University Trained Physical Therapists. 2009;16(1):34-41.
  17. van Vlimmeren LA, Helders PJ, van Adrichem LN et al. Torticollis and plagiocephaly in infancy: therapeutic strategies. Pediatr Rehabil. 2006;9(1):40-6.
  18. Canale ST, Griffin DW, Hubbard CN. Congenital muscular torticollis. A long-term follow-up. J Bone Joint Surg Am. 1982;64(6):810-6.
  19. An HS, Lee SJ. Construction of a reference stature growth curve using spline function and prediction of a final stature in Korean. Korean J Othod. 2007;37(1):16-28.