• Journal of Korean Medicine Rehabilitation
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• v.19 no.4
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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.

• 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.

• 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.

• Korean Journal of Oriental Medicine
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• v.3 no.1
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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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• v.9 no.3
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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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• v.60 no.1
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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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• v.46 no.5
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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.

• Archives of Plastic Surgery
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• v.51 no.1
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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.

• Journal of Korean Physical Therapy Science
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• v.3 no.1
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• pp.863-870
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• 1996

The 46 patients were investigated with the congenital infant muscular torticollis referred Dept. of physical therapy in Dong San Medical Center from January in 1995 to January in 1996. 1. The ratio between males and females was scaled to 1.5 : 1.23 cases(50.0 %) were involved with left side and 22 cases(47.8 %) involved with right side, and one case was of bilaterality. 2. Sequence of birth, the first bone babys were the most distributed with 34cases(73.9 %), the second bone babys were followed with 11cases(23.9 %). 3. There were normal deliveries 60.8 %, Cearean section deliveries 23.9 %, difficulty deliveries .0 % and breech presentation was 2.2 %. 4. The case of cephalic asymmetry consisted 60.0 % of all congenital torticollis and most frequently found at the age of all $5\sim8$ weeks(45.7 %). In 26.1 % of all congenital torticollis cases, facial asymmetry was found and these cases were most frequently in the age of $5\sim8$ weeks(26.1 %), also in the age group of $9\sim12$ weeks and $17\sim20$ weeks consecutively(each 3 %).(P<0.05) 5. The duration of therapy required differently according to the severity of the torticollis, in mild cases, it took $1\sim2$ weeks cases(30.4 %) revealed high therapeutic effect in 54.3 % of the cases. In moderately involved cases(30.4 %), therapy required $3\sim4$ weeks in 13 % of the cases showed improvements. In the most severely involved cases, (7 %) it took more than $9\sim10$ weeks of therapy and showed improvement in 6.5 % only.(P<0.005) 6. The result of this study showed the best therapeutic effects were noticed in the mild cases of congenital torticollis(24 cases 45.6 %) and excellent improvement in moderately involved cases (28.1 %) and 13.1 % of the most severely involved cases(P<0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.388-395
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• 1996

Congenital muscular torticollis(CMT) is a disorder characterized by shortening of at least one of the cervical muscles and tilting of the head to opposite side. The most commonly affected muscle is the sternocleidomastoid muscle. Pathogenesis and etiology of congenital muscular torticollis were not clearly identified, but considered as fetal malposition, birth trauma, vascular accident, heredity, infection and CNS pathology. Untreated congenital muscular torticollis often causes facial asymmetry and This is the rasult of tensional rotation of the face toward affected side. So early treatment may prevent facial and neck asymmetry and limitation of neck movement. There are many treatment methods in CMT, including conservative and operative method, but presently Bipolar release and Z-Plasty of SCM muscle has been introduced when the conservative treatment had failed. The benefits of this method are to preservation of the normal Neck V-contour and improvement of the neck motion. We treated CMT using Bipolar release and Z-plasty in two patients. After that the patients improved on the range of neck motion and maintained the normal V-conture of the neck, so we report two cases of CMT with literatures.