Assessing Congenital Muscular Torticollis Using Myotonometry: A Novel Approach

Area of Science:

• Pediatric Physical Therapy
• Musculoskeletal Ultrasound
• Infant Biomechanics

Background:

• Congenital Muscular Torticollis (CMT) is a common pediatric condition characterized by sternocleidomastoid (SCM) muscle imbalance.
• Accurate assessment of SCM muscle properties is crucial for monitoring treatment efficacy in infants with CMT.
• Myotonometry offers a non-invasive method to evaluate muscle biophysical properties.

Purpose of the Study:

• To assess sternocleidomastoid (SCM) muscle properties in infants diagnosed with Congenital Muscular Torticollis (CMT) using myotonometry.
• To determine the sensitivity of myotonometry in detecting changes in SCM muscle properties following an 8-week physiotherapy program.
• To correlate myotonometry findings with traditional measures of muscle strength and neck range of motion.

Main Methods:

• Twenty-five infants (0-12 months) with CMT underwent an 8-week physiotherapy intervention.
• Myotonometry was used to measure SCM muscle tone, elasticity, and stiffness on affected and unaffected sides before and after treatment.
• Muscle Function Scale (MFS) and arthrodial protractor were employed to assess muscle strength and neck range of motion, respectively.

Main Results:

• Pre-treatment, significant differences in SCM muscle tone and stiffness were observed between the affected and intact sides (p<0.05).
• Post-treatment, intra-group analysis revealed significant improvements in muscle tone (p=0.005), elasticity (p=0.009), stiffness (p=0.009), strength (p=0.006), and neck range of motion (p=0.021).
• Muscle tone decreased by 19.65%, stiffness by 24.99%, elasticity improved by 9.42%, passive lateral flexion increased by 59.09%, and passive rotation by 25.40%.

Conclusions:

• Myotonometry effectively detects improvements in sternocleidomastoid muscle properties in infants with Congenital Muscular Torticollis following physiotherapy.
• The study highlights myotonometry as a valuable clinical tool for evaluating treatment response in pediatric torticollis.
• Further research with larger sample sizes is recommended to validate these findings.