• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.176-189
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• 2020

Purpose To evaluate the clinical efficacy of real-time sonoelastography (RTS) for the follow-up of congenital muscular torticollis, based on measurements of muscle elasticity. Materials and Methods Thirty-four infants (23 male, 11 female) with congenital sternocleidomastoid (SCM) muscle torticollis underwent ultrasonography and elastography between November 2012 and December 2014. We evaluated the thickness, morphology (mass-like, fusiform, or overall thickened shape), and echogenicity of the SCM muscle on grayscale images and color patterns (homogeneous blue, mixed green < 50% and ≥ 50%, and green to red) on elastography. Strain ratios were measured using Q-lab software. A clinician classified the degree of neck rotation and side flexion deficits using a 5-point grade system based on angles of neck rotation and side flexion. Correlations between the ultrasonography and clinical findings were evaluated by statistical analysis. Results Twenty-two infants had right and 12 had left SCM torticollis, respectively. Linear regression analysis showed that involved/contralateral SCM thickness differences, morphology, elasticity color scores, and strain ratios of the affected SCM muscles were significantly correlated with neck rotation and side flexion deficit scores (p < 0.05). The elasticity color score of the affected SCM muscle was the most significant factor. Conclusion RTS might provide a reliable means for evaluating and monitoring congenital muscular torticollis.

• Journal of Practical Agriculture & Fisheries Research
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• v.21 no.2
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• pp.71-76
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• 2019

There have been no reports on the laboratory screening of congenital torticollis in equine medicine. The purpose of this study was to evaluate the blood chemistry of a newborn female foal with congenital torticollis. The filly was born after a normal parturition period, and the clinical pathology results were as follows: biochemistry of the plasma showed significantly higher levels of CK, LDH, and Na than those in a normal foal. However, Cl level was remarkably lower than that of the control. In conclusion, the cells in the neck muscles influenced the clinical pathological value in the neonate. A disorder of the muscles as well as the bone problem, such as the cervical vertebrae, may have caused congenital torticollis. To our knowledge, this is the first report detailing the clinical pathology results in a newborn foal with torticollis. These laboratory results can be used as a reference for interpretation of pathology results in foals.

• The Journal of the Korea Contents Association
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• v.13 no.9
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• pp.270-280
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• 2013

The Purpose of this study was to investigate the relationship between congenital muscular torticollis and maternal work activity. This study was conducted with a total of 89 outpatient pregnant women whose child presented congenital muscular torticollis at the Department of Rehabilitation of "C" Hospital in Suwon within the period from 2006 to April 30, 2011. The results were as followings: (1) The mean age at the time of giving birth was 30.09years; the proportion of pregnant women with college education or higher was high; the proportion of first delivery was 82.0%; the most common way of delivery was natural childbirth, followed by Cesarean section and vacuum extraction; the proportion of breech delivery was 20.2%; and in 82.0% of the women, the first child had congenital muscular torticollis. (2) 59.6% of the women had a career; 45.3% had engaged in professional practice or had a related job; 75.5% had worked until the third trimester of their pregnancy; 54.7% had worked for seven hours or more in a seated position; and the mean number of working hours was 8.75 (3) The level of work-related stress was a low 25% or less, and in the subdivisions of work-related stress, only the level of strained relations belonged to the upper 50% or higher. (4) For the correlation between the survey respondents' job stress and job features, stress (full score: 100 points) showed a strong positive correlation with job demand, strained relations, inadequate reward, and workplace culture. Workplace also showed a strong positive correlation with inadequate reward. Mean daily working hours showed a strong positive correlation with mean weekly working hours.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1273-1278
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• 2009

Purpose:Congenital muscular torticollis (CMT), a common musculoskeletal disorder in infants, is characterized by the rotation and flexion deformity of the neck caused by sternocleidomastoid muscle shortening. We investigated the clinical courses and perinatal risk factors of CMT. Methods:Less than 6-month-old patients (98; M:F = 60:38) diagnosed with CMT between February 2007 and August 2008 were classified into 2 clinical subgroups, namely, SMT (sternocleidomastoid tumor) and POST (postural torticollis). All the patients were physically and neurologically examined prospectively and their cervical X-rays and ultrasonographies were obtained. Their medical histories about perinatal problems were recorded. Of the 98 patients, 45 with normal range of motion were taught passive physical exercises and 43 were referred to the Department of Rehabilitation for undergoing manual stretching therapy. Results:The mean age at initial assessment was 2.2 months (SMT: $1.4{\pm}1.0$, POST: $2.7{\pm}1.6$). SMT presented earlier than POST. All ophthalmologic examinations and cervical X-rays were normal. SMT was associated with higher incidence of caput succedaneum and cephalhematoma. POST was highly associated with plagiocephaly. Mean duration of rehabilitative physical therapy was 3.7 months (SMT: $4.6{\pm}2.5$, POST: $2.6{\pm}1.9$). POST resolved earlier than SMT. Of the 88 patients with follow-up, 87 had total resolution and only 1 had residual torticollis. Conclusion:All the patients received early treatment with passive stretching exercises. CMT was associated with perinatal problems and had various risk factors such as obstetrical problems.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.38-45
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• 2009

Purpose: The congenital muscular torticollis is a neck deformity involving shortening of the sternocleidomastoid muscle, which is detected at birth or shortly after birth. This childhood disease is the third most common congenital musculoskeletal anomaly. The indication for surgery is a persistent head tilt with dificit of passive rotation and lateral bending of the neck and a tight band or tumor in the sternocleidomastoid muscle even after physical therapy. The purpose of this article is to report surgical outcomes with patients who had no or little response to physical therapy. Methods: Surgery was performed on 29 patients and their average age was 4.1 years (from 6 months to 20.1 years). The unipolar open release and partial myectomy were done in 28 cases and the muscle lengthening was done in 1 case. Physical therapy was started from postoperative seventh day. Follow - up period was ranged from 2 months to 5.4 years(mean follow - up, 20.4 months). Result: There were neither rotation nor lateral bending deficit after surgical treatment. Mild head tilt was noticed in 3 cases and residual bend was observed in 4 cases. The subjective assessments of surgical results by parents were excellent. Conclusion: Our surgical outcome encourages the surgical treatment of congenital muscular torticollis for patients who failed to respond to physical therapy.

• Physical Therapy Korea
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• v.13 no.2
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• pp.77-84
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• 2006

Although conservative management of congenital muscular torticollis (CMT) has been well documented, relatively little is known about the response to the treatment. The purposes of this case report were to describe the use of a therapeutic approach based on motor development in physical therapy intervention for an infant with CMT and to report the result of the treatment. The patient was a 20-day-old baby boy with left CMT presenting muscular mass in the left sternocleidomastoid muscle. The angle of the lateral head tilt was 20 degrees. The size of muscular mass was 5.3 mm in ultrasonography. Intervention included ultrasonic therapy, soft tissue massage, passive and active range of motion exercises, motor developmental therapy, and parent instruction. The procedures of motor developmental therapy and changes in the amount of lateral head tilt were documented using photography. The size of the mass was decreased to .3 mm before the 5-month follow-up. The patient also maintained a midline head position in the supine position and a midline head alignment during all functional activities. A therapeutic approach based on motor development is a beneficial method for reducing an asymmetrical head and neck position, and facilitating normal development as a component of physical therapy intervention.