A study on asymmetry in infants with congenital muscular torticollis according to head rotation.
KyeongSoo Lee, EunJung Chung, Byoung-Hee Lee
PMID 28210037WHAT IT FOUND
Infants with congenital muscular torticollis improved in overall assessment scores and head tilt after six months of ultrasound, massage, manual stretching, and passive stretching.
More severe rotation asymmetry started with worse scores. No control group means the study cannot show which component caused change.
Key findings
01Torticollis overall assessment scores increased over time in all severity groups, and the groups remained significantly different from each other at 6 months.
02Average head tilt decreased in all groups from baseline to 3 months and to 6 months: Grade I from 12.05 to 3.82 and 1.95 degrees, Grade II from 15.06 to 4.94 and 3.31 degrees, and Grade III from 18.25 to 6.31 and 2.75 degrees.
03At 6 months, the head tilt groups were no longer significantly different from each other, although the within-group changes were significant.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was no untreated comparison group, so the study cannot show what would have happened without treatment. All infants received therapeutic ultrasound, massage, manual stretching, and passive stretching together, so the contribution of any single component cannot be separated. Infants were grouped by severity rather than randomly assigned, so differences between groups may reflect baseline severity rather than treatment response. The paper does not state a pre-specified primary outcome; it reports overall assessment and head tilt together. The torticollis overall assessment score is not explained in the supplied text, so readers cannot tell how much a score change means clinically. Parent-reported cosmetic and functional concerns are part of the overall score, which may make the outcome subjective. Follow-up was only 3 and 6 months, so longer-term asymmetry or recurrence is not shown. Head tilt was measured from photographs by physical therapists, but blinding and inter-rater agreement are not reported.
The easy way to misread this
Do not read the improvement as proof that any one treatment caused it. All infants received therapeutic ultrasound, massage, manual stretching, and passive stretching together, and there was no untreated comparison group.