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The Physical Therapy Assessment and Management of Infants with Congenital Muscular Torticollis. A Survey and a Suggested Assessment Protocol for CMT

Anna M Öhman, Eva-Lott Mårdbrink, Christina Orefelt, Anthea Seager, Lisen Tell and Eva Arrenhius Klackenberg

Background: Infants with congenital muscular torticollis(CMT) are treated with physical therapy, however the knowledge about type of assessment and treatment in current clinical practice is not clear.

Aim: This study aimed to investigate the management of infants with CMT within a network of physical therapists.

Settings/population: Physical therapists from a network for CMT participated in the study.

Method: With permission a questionnaire from New Zealand was used. Subsequently an expert group of physical therapists developed a draft assessment protocol.

Result: In general there was a high degree of consensus between the respondents in the current survey. For the assessment visual estimates were most commonly used and an evaluation of cervical muscle strength of the neck was always/often conducted. The most effective form of intervention as perceived by the respondents in the management of CMT was passive stretching, handling advice, facilitation with strengthening exercises of the neck muscle and facilitation of active cervical range of motion. There were big discrepancies in assessment of hand- and hip asymmetry.

Conclusion: There seems to be a need to develop international guidelines for CMT to improve the evidence practice of assessment and treatment.