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Published on: December 31, 2013
Perception-Action Approach Versus Standard Care for Infants With Congenital Muscular Torticollis: A Pilot
Mary Rahlin1, Nancy B Haney2, Joyce Barnett3
1Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA.
Insights
The Perception-Action Approach (P-AA) showed similar short-term benefits to standard care for infants with congenital muscular torticollis (CMT). While P-AA group infants had higher symmetry and behavior scores, further research is needed to confirm these findings.
Area of Science:
- Pediatrics
- Physical Therapy
- Developmental Pediatrics
Background:
- Congenital muscular torticollis (CMT) is a common condition in infants requiring effective interventions.
- The Perception-Action Approach (P-AA) is an intervention strategy with potential benefits for infants with CMT.
- Standard care serves as a benchmark for evaluating new therapeutic approaches in CMT management.
Purpose of the Study:
- To compare the short-term outcomes of the Perception-Action Approach (P-AA) versus standard care for infants with congenital muscular torticollis (CMT).
- To evaluate changes in postural alignment, motor symmetry, gross motor development, and infant behavior during therapy.
- To assess the feasibility of P-AA as a first-choice intervention based on clinical practice guidelines.
Main Methods:
- A randomized, single-blind pilot study involving 32 infants diagnosed with CMT (age 5-35 weeks).
- Participants were assigned to either the P-AA group or the standard care group, each receiving 3 intervention sessions.
- Outcome measures included still photography, arthrodial goniometry, Muscle Function Scale, Alberta Infant Motor Scale, and Functional Symmetry Observation Scale, alongside the Therapy Behavior Scale Version 2.2.
Main Results:
- Twenty-four infants completed the study due to COVID-19 pandemic interruptions.
- Both groups demonstrated improvements in most outcome measures, with no statistically significant differences between P-AA and standard care.
- The P-AA group showed a trend towards greater gains in functional symmetry and improved therapy behavior scores, though not statistically significant.
Conclusions:
- The pilot study suggests that P-AA and standard care yield similar short-term outcomes for infants with CMT.
- Definitive conclusions on P-AA efficacy require larger, adequately funded future trials.
- This study provides preliminary data for a future randomized controlled trial investigating P-AA in infants with CMT.
Objective:
The purposes of this pilot study were to compare short-term outcomes of the Perception-Action Approach (P-AA) and standard care based on 5 components of first-choice interventions listed in the congenital muscular torticollis (CMT) clinical practice guideline. Changes in postural alignment, symmetrical use of both sides of the body during movement and play, gross motor development, and behavior observed during therapy were considered.
Methods:
Thirty-two participants were enrolled in a 2-group (P-AA and standard care) randomized, single-blind trial with pre-posttest measures. Participants were infants with CMT, age range 5 to 35 weeks at enrollment. Outcome measures administered at initial and final evaluations included still photography, arthrodial goniometry, Muscle Function Scale, Alberta Infant Motor Scale, and Functional Symmetry Observation Scale. Participants in both groups attended 3 intervention sessions. Their behavior exhibited during therapy was compared using the Therapy Behavior Scale Version 2.2.
Results:
Data collection was interrupted by the COVID-19 pandemic lockdown. Twenty-four infants completed the study (10 in P-AA and 14 in the standard care group). There were no significant differences between the groups in performance at initial and final evaluations. Both groups improved on most outcome measures. The P-AA group made greater gains on the Functional Symmetry Observation Scale, and the Therapy Behavior Scale Version 2.2 scores were higher in the P-AA group; however, these results did not reach significance.
Conclusion:
Results suggest that similar short-term outcomes may be obtained in infants with CMT undergoing P-AA and standard care interventions. Definitive conclusions regarding the efficacy of the P-AA in infants with CMT cannot be made at this time. Nevertheless, the pilot findings provide valuable preliminary data for a future efficacy trial, which will require funding.
Impact:
This was the first randomized controlled trial to provide evidence for use of P-AA intervention in infants with CMT.
Lay Summary:
Compared to standard treatment, the Perception-Action Approach (P-AA) provided similar short-term benefits to infants with congenital muscular torticollis. The P-AA group participants demonstrated higher symmetry and behavior scores, which needs to be confirmed in a larger future study.
