Author:
Zhao Zhenhui,Deng Hansheng,Qiu Xin,Tang Gen,Zheng Huijia,Yang Fang,Gao Futang,Wu Zhengyu,Li Yuanheng,Zeng Shuaidan,Zhao Jiaxin,Sun Yiyuan,Zhou Ziheng,Tang Yu,Cui Zhiwen,Li Weiqing,Chen Xiaodi,Cai Ting,Liu Xian,Li Shicheng,Yang Qisong,Tang Shengping,Xiong Zhu
Abstract
Abstract
Purpose
To investigate the factors influencing and long-term effects of manual myotomy (MM) occurring during physiotherapy for congenital muscular torticollis (CMT).
Methods
We retrospectively collected the clinical data of children with CMT receiving physiotherapy between 2008 and 2018. The children were divided into manual myotomy (MM) and non-manual myotomy (NMM) groups according to whether MM occurred during treatment. We assessed physiotherapy outcomes in children with CMT using craniofacial asymmetry parameters and the Cheng–Tang rating score. By measuring the ear-eye distance, ear-nose distance, eye-mouth distance, ear-mouth distance, half-head circumference, and half-head top at two sides to evaluate craniofacial asymmetry. Based on the Cheng–Tang assessment criteria, we recorded the range of rotation, range of lateral flexion, the status of the contracted muscle, the hardness of the mass, the extent of head tilting during activities and sleeping, the status of daily activities, face size, type of head shape, cranial changes, and subjective head tilting to assess the effectiveness of treatment. Clinical data and outcome indicators (craniofacial asymmetry parameters and Cheng–Tang rating score) were compared.
Results
The MM group had a significantly higher total Cheng–Tang rating score than the NMM group (P < 0.05). Age at initial physiotherapy session was the risk factor for MM during physiotherapy.
Conclusion
Children with CMT developing MM during physiotherapy generally have a good outcome, although we do not recommend MM as a goal of treatment. Physiotherapists should understand this phenomenon, assess relevant factors to predict risk, and carefully observe treatment to prevent possible complications.
Funder
Sanming Project of Medicine in Shenzhen
Shenzhen Fund for Guangdong Provincial High-level Clinical Key specialties
Shenzhen Innovation Science and Technology Committee
Hospital-level project of Shenzhen Children's Hospital
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Rheumatology
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