Motor development and sensory processing skills in infants with congenital muscular torticollis: a cross-sectional
Rabia Zorlular1, Sinem Erturan Burak2, Rana Beyoglu3
1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Nigde Omer Halisdemir University, Nigde, Turkey. rabiaeraslan118@gmail.com.
Insights
Infants with congenital muscular torticollis (CMT) experience delays in motor development and sensory processing. Early screening and intervention are crucial for addressing these challenges in infants with CMT.
Area of Science:
- Pediatric Physical Therapy
- Developmental Pediatrics
- Neonatal Neurology
Background:
- Congenital muscular torticollis (CMT) involves sternocleidomastoid muscle shortening, leading to limited neck movement and potential impacts on vestibular and proprioceptive input.
- Limited range of motion in infants with CMT can negatively affect balance and body awareness, highlighting the need for further investigation into developmental outcomes.
Purpose of the Study:
- To evaluate and compare motor development and sensory processing skills in infants with congenital muscular torticollis (CMT) against typically developing peers.
- To investigate the relationship between SCM muscle characteristics and developmental outcomes in infants with CMT.
Main Methods:
- A cross-sectional study involving 4-6-month-old infants with muscular-type CMT and age-matched controls.
- Motor development assessed using the Peabody Developmental Motor Scales-Second Edition (PDMS-2); sensory processing evaluated with the Test of Sensory Functions in Infants (TSFI).
- SCM muscle thickness measured using computer-assisted ultrasonography.
Main Results:
- Infants with CMT demonstrated significantly lower scores in TSFI for tactile deep pressure, ocular-motor control, and overall sensory processing compared to controls.
- PDMS-2 assessments revealed significantly lower gross motor, fine motor, and total motor scores in infants with CMT.
- Moderate to large effect sizes were observed for both total motor and total sensory processing scores, indicating significant developmental differences.
Conclusions:
- Infants diagnosed with congenital muscular torticollis exhibit significant delays in both sensory processing and motor development.
- These findings underscore the importance of early developmental screening and timely intervention for infants with CMT to mitigate long-term challenges.
Abstract:
Congenital muscular torticollis (CMT) is characterized by asymmetric head posture due to unilateral shortening or fibrosis of the sternocleidomastoid (SCM) muscle. This study aimed to evaluate motor development and sensory processing skills in infants with CMT and compare them with typically developing peers. In this cross-sectional study, term infants aged 4-6 months with muscular-type CMT and age-matched controls were assessed at Gazi University between February and May 2025. Motor development was evaluated using the Peabody Developmental Motor Scales-Second Edition (PDMS-2), and sensory processing was assessed via the Test of Sensory Functions in Infants (TSFI). In infants with CMT, the thickness of the SCM muscle was measured using computer-assisted ultrasonography. A total of 22 infants with CMT (10 females) and 21 typically developing peers (9 females) participated in the study. Demographic characteristics were similar between groups. Compared to controls, infants with CMT had significantly lower scores in TSFI tactile deep pressure (p = 0.01), ocular-motor control (p < 0.001), and total score (p = 0.002), as well as in PDMS-2 gross (p = 0.03), fine (p = 0.04), and total motor scores (p = 0.02). Effect sizes were moderate to large (Cohen's d = 0.79 for total motor, d = 1.12 for total TSFI).
Conclusion:
Infants with congenital muscular torticollis show delays in sensory processing and motor development. Early developmental screening and intervention may help identify and address these difficulties.
Trial Registration:
The study was registered on ClinicalTrials.gov on March 10, 2025, under the number NCT06879314.
What Is Known:
• The unilateral shortening or tightness of the sternocleidomastoid muscles can limit neck and head movements. • Limited range of motion impairs vestibular and proprioceptive input, negatively affecting balance and body awareness.
What Is New:
• Infants with congenital muscular torticollis may exhibit delays in both gross and fine motor development compared to their typically developing peers. • Infants with congenital muscular torticollis may also demonstrate impairments in sensory processing skills, including tactile and ocular-motor domains.
