CONGENITAL MUSCULAR TORTICOLLIS AND CRANIAL DEFORMATION: SUPPORT FOR CONCURRENT TREATMENT

Congenital muscular torticollis (CMT) and cranial deformation (CD) develop in-utero or shortly after birth; each condition is a risk factor for the other. Most infants with CMT referred to PT have a good outcome, although recent studies indicate 33% - 50% do not have full resolution of symptoms. CD has been shown to increase PT utilization and may be a factor contributing to poorer outcomes. Given the strong relationship between CMT and CD, it is reasonable to propose that concurrent treatment of these co-diagnoses may reduce PT utilization, while optimizing outcomes. Evidence for concurrent treatment is limited. The purpose of this study was to investigate outcomes for infants with CMT and CD who received early concurrent treatment. With early concurrent treatment, all infants resolved CMT and most corrected CD. We had a higher percentage of infants with full resolution of CMT while using fewer PT visits compared to two recently published retrospective studies. Infants in these studies were older and it is unclear if they had CD or were being treated for CD. Our results provide preliminary support for early concurrent treatment of CMT and CD to reduce PT utilization and increase full resolution of symptoms, but more research is needed. Physical therapists may consider using specific RT to treat CD for infants with both conditions, especially between 2 and 4 months before referral to orthotist typically occurs.