• 한국전문물리치료학회지
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• 제16권1호
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• pp.34-41
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• 2009

The purpose of this study is to compare the outcomes of manual stretching treatment with those of motor development and positioning physical therapy (MDPPT) for congenital muscular torticollis (CMT). This study was designed to be randomized controlled trials and to evaluate the outcomes of 43 consecutive patients with CMT who were first seen when they were average 26 days old. Before treatments, the patients were unintentionallv classified into two clinical groups along with the treatment methods. Among the 43 patients, 22 were classified to the manual stretching group and 21 to the MDPPT group. By means of independent t-test on the result. the duration of treatment according to methods was not significantly different in two groups (p>.05). The duration of treatment in accordance with head tilt level was not significantly different in two groups (p>.05). There was change of mass diameter, between at the beginning day of treatment and after treatment in manual stretching group with a strong positive linear correlation (p=.000, r=.734), but slightly positive linear correlation in MDPPT group. The result of this study indicates that two therapeutic methods make little difference in effectiveness.

• 한방재활의학과학회지
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• 제19권4호
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• pp.229-236
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• 2009

Objectives : The purpose of this study is to report one case of spinal scoliosis patient with neglected congenital muscular torticollis treated by chuna manual therapy. Methods : The patient had been treated with chuna manual therapy. Full spine anteroposterior X-ray was taken to measure cobb's angle and cervico-mandibular angle before and after the period of treatment. Results : After treatment, the cobb's angle has been improved by $12^{\circ}$($31^{\circ}$ to $19^{\circ}$) at thoracic level, by $7^{\circ}$($17^{\circ}$ to $10^{\circ}$) at lumbar level. The cervico-mandibular angle has been improved by $5^{\circ}$($14^{\circ}$ to $9^{\circ}$). Conclusions : Chuna manual therapy was effective for a scoliosis patient with neglected congenital muscular therapy.

• 한국콘텐츠학회논문지
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• 제13권9호
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• pp.270-280
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• 2013

본 연구의 목적은 선천성 근육사경과 산모의 직업적 활동 간의 관련성을 알아보는 것이다. 2006년부터 2011년 4월까지 수원 "C" 병원 재활의학과를 내원한 선천성 근육사경아동의 산모 89명을 대상으로 실시하였다. 결과는 첫째, 연구대상자의 일반적 특성을 보면, 출산 평균연령은 30.09세, 교육수준은 대졸이상이 많았으며, 초산이 82.0%로 나타났으며, 자연분만, 제왕절개, 흡입분만 순이었고, 분만 시 둔위여부는 20.2%로 나타났으며, 첫째 아동이 사경인 경우가 82.0%로 나타났고, 둘째, 연구대상자의 직업적 특성에서 직장생활을 한 산모가 59.6%이고 전문가 및 관련종사자가 45.3%를 차지하였고, 직장생활을 임신 3기까지 한 산모가 75.5%로 나타났고, 주로 서서 일하는 자세보다 앉아서 일하는 자세로 앉아서 일하는 시간이 7시간 이상이 54.7%로 나타났으며, 하루 평균 근무시간은 8.75시간으로 나타났고, 셋째, 연구대상자의 직무스트레스는 하위 25%이하 수준으로 나타났으며, 하위 요인별 정도에선 관계갈등영역에서만 상위 50%이상으로 나타났다. 넷째, 연구대상자의 직무스트레스와 직업적 업무 특성간의 상관관계를 보면, 스트레스(100점 환산)와 직무스트레스의 직무요구, 관계갈등, 보상 부적절, 직장문화와 양의 상관관계가 높게 나타났으며, 직장문화와 보상 부적절간에도 양의 상관관계가 높게 나타났다. 직업적 업무 중 하루 평균 근무시간과 평균 일주일 근무시간과 양의 상관관계가 높게 나타났다.

• 한국전문물리치료학회지
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• 제13권2호
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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.

• 한국한의학연구원논문집
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• 제3권1호
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• pp.215-228
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• 1997

Extrapyramidal movement disorders are divided descriptively into hypokinesias(such as parkinsonism), characterized by poverty and slowness of movement : hyperkinesias(such as chorea, athetosis, dystonia, ballism, etc.), manifested by abnormal involuntary movement. Chorea refers to widespread arrythythmic movements of a forcible, rapid, jerky, restless type Choreic movements are noted for their irregularity and variability. They are generally continuous, may be simple or quite elaborate, and affect any part of the body. Dystonla refers to abnormally increased muscular tone that causes fixed abnormal postures. Some patients with dystonia also have shifting postures, resulting from irregular, forceful twisting movement that affect trunk and produce bizarre, grotesque movements and positions of the body. The most frequent and familiar type of focal dystonia is spasmodic torticollis. It consists of an involuntary turning of the head to one side - intermittent at first, then gradually worsening to the point of being more or loss continuous. The combination of blepharospasm and oromandibular dystonia is sometimes refered to as Meige's syndrome. We report two patients with dystonia and chorea in cerebral infarction at basal ganglia. We have experienced good improvement by the oriental medicine and acupuncture treatment.'rho acupuncture points of LI 4, ST 36, TE 3, GB 34, GB 41, LR 3, GB 39 were used. The therapies of herb-medicine were treated by Zibu-Ganshen(滋補肝腎), Huoxue-Xifeng-Tongluo(活血息風通絡).

• Physical Therapy Rehabilitation Science
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• 제9권3호
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• pp.191-196
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• 2020

Objective: Congenital muscular torticollis (CMT) is a disease with abnormal head and neck posture in infants. It affects the child's movement and development and can lead to complications. Therefore, this study aims to find out what factors influence the rehabilitation treatment duration of infants with CMT. Design: Cross-sectional study. Methods: The subjects were 63 infants under 90 days of age who were diagnosed with CMT. Age, thickness of the sternocleidomastoid muscle (SCM) on the affected and non-affected side, head tilt angle, and head rotation angle of the affected head in infants were collected. The ratio of muscle thickness was calculated from the thickness of the affected SCM and the thickness of the non-affected SCM (A/N ratio). All subjects underwent conservative physical therapy twice a week for 30 minutes, and the end of the treatment was when the angle of head tilt was normal or less than 5 degrees, and the treatment duration was calculated. Results: Age, thickness of affected SCM, and head tilt were significantly correlated with treatment duration (p<0.05). The thickness of the non-affected SCM, A/N ratio, and head rotation angle did not show any correlation with treatment duration. The factors affecting the treatment duration were head tilt and age, showing 21% explanatory power of adjusted R². Conclusions: The main factors affecting the treatment duration of infants with CMT are head tilt and age. Therefore, more attention should be directed to the infant's head tilt and age for effective physical therapy of infants with CMT.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.82-88
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• 2017

Objective : We assessed the surgical results of bipolar release in 31 adult patients with uncorrected congenital muscular torticollis (CMT) and more than 12 months of follow-up. Methods : Thirty-one patients underwent a bipolar release of the sternocleidomastoid muscle (SCM) and were retrospectively analyzed. The mean follow-up period was 14.9 months (range, 12-30). The mean age at time of surgery was 30.3 years (range, 20-54). Patients were evaluated with a modified Lee's scoring system, cervicomandibular angle (CMA) measurement, and a global satisfaction rating scale using patient self-reporting. Results : The modified Lee's scoring system indicated excellent results in 4 (12.9%) patients, good in 18 (58.1%), and fair in 9 (29.0%) at the last follow-up after surgery. The improvements in neck movement and head tilt were statistically significant (p<0.05). The preoperative mean CMA was $15.4^{\circ}$ (range, 5.4-29.0), which was reduced to a mean of CMA of $6.3^{\circ}$ (range, 0-25) after surgery (p<0.05). The global satisfaction rating scale was 93.7% (range, 90-100). A transient sensory deficit on the ipsilateral lower ear lobe was noted in three cases. No significant permanent complications occurred. Conclusion : Bipolar release of the SCM is a safe and reliable technique for the treatment of CMT in adults.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.414-420
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• 2019

Background Congenital muscular torticollis (CMT) is characterized by persistent head tilt toward the affected side. No consensus exists regarding the cause of this disorder. In this study, we analyzed various clinical factors in patients with CMT who were treated with surgical release. This analysis enabled us to identify potential causative factors of CMT and to establish a basis for surgical interventions. Methods In total, 584 patients who underwent surgical intervention for CMT from October 2007 to December 2016 were included in this study. Their demographic characteristics, birthrelated factors, and clinical features were analyzed. Results Data from 525 patients were analyzed in this study after exclusion of those with insufficient information. Before birth, 31 patients (5.9%) were diagnosed with oligohydramnios, and 87 (16.6%) had a breech presentation. Seven (1.3%) cases of clavicle fracture and two (0.4%) cases of cephalohematoma were noted at birth. Before surgery, 397 patients (75.6%) underwent physiotherapy and 128 patients (24.4%) did not. The duration of physiotherapy ranged from 1 to 50 months (average, 6 months). Conclusions Our study shows that 16.6% of the CMT patients presented in the breech position, which is a much higher rate than that observed in the general population (3%-4%). We hypothesize that being in the breech position as a fetus appears to exert a significant influence on shortening and fibrosis of the sternocleidomastoid muscle.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1374-1382
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• 2020

Objective: To determine whether ultrasonography at initial presentation can help assess the clinical severity of congenital muscular torticollis (CMT) in infants without a sternocleidomastoid muscle (SCM) mass. Materials and Methods: This retrospective study included 71 infants aged less than 12 months (4.1 ± 2.3 months) with non-mass CMT. The clinical severity was divided into three grades (groups 1-3) based on the degree of lateral head bending or cervical rotation. The difference (SCM-D) and ratio (SCM-R) between the maximal thickness of the affected and non-affected SCMs were obtained using transverse and longitudinal ultrasonography. The sonographic echotexture and echogenicity of the involved SCM were reviewed. Results: A significant difference was observed in the SCM-D (0.42 ± 0.30 mm in group 1; 0.74 ± 0.50 mm in group 2; 1.14 ± 0.85 mm in group 3; p = 0.002) and SCM-R (1.069 ± 0.067 in group 1; 1.129 ± 0.087 in group 2; 1.204 ± 0.150 in group 3; p = 0.001) among the groups when measured along the longitudinal but not along the transverse ultrasonography plane. The areas under the curves of the SCM-R and SCM-D measured by longitudinal ultrasonography were 0.731 (p < 0.001) and 0.731 (p < 0.001) for group 1 versus groups 2-3. The proportions of heterogeneous echotexture or hyperechogenicity in the involved SCM did not differ significantly among the three clinical groups (all p > 0.05). Conclusion: Ultrasonography can aid in assessing the clinical severity of CMT in infants without an SCM mass at the time of initial diagnosis. The SCM-R and SCM-D helped grade the clinical severity when obtained by longitudinal scan.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.72-79
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• 2024

Background Congenital muscular torticollis (CMT) is a common musculoskeletal disorder in children. Secondary scoliosis can occur in patients with CMT; however, the extent of inclination and improvement of scoliosis after surgical correction of CMT have not been adequately studied. In this study, we aimed to evaluate and measure the improvement in vertebral tilting after surgical correction according to age at the time of surgery. Methods Between June 2007 and January 2020, 831 patients with CMT underwent sternocleidomastoid release. Among them, 426 patients were enrolled, and their medical records were retrospectively reviewed. Ultimately, 210 patients available for radiological evaluation and analysis were enrolled in this study. The patients were divided into four groups according to age at the time of surgery to determine the relationship between age and changes in scoliosis. Results Our findings showed an improvement in scoliosis in all age groups after surgery. The results for follow-up after 1 year confirmed long-term improvement in vertebral tilting. The degree of improvement in scoliosis was significantly higher in the younger age group than in patients aged 18 years or older. Conclusion The effect of surgical release on scoliosis was significant in all age groups. The findings of this study suggest that CMT should be corrected before the age of 3 years to ensure an optimal surgical mitigation of scoliosis. Furthermore, in cases of neglected CMT, surgical release should be actively attempted because there is significant improvement.