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Considerations and intervention in congenital muscular torticollis.

PURPOSE OF REVIEW: To present the current literature regarding congenital muscular torticollis (CMT) to promote the most effective and evidence-based intervention. CMT is a musculoskeletal deformity observed at birth or in infancy, characterized by persistent head tilt toward the ipsilateral side with the chin rotated toward the contralateral side. The incidence of torticollis is on the rise and as a result there has been a surge in the literature on the topic, however, until recently, there was little consensus on the treatment approach.

RECENT FINDINGS: Research on CMT has gone in several directions. One branch is looking at diagnostics, imaging, and attempting to understand the underlying disease behind torticollis, down to the cellular level. This information may be helpful in the other, more clinical research vein to determine prognosis, establish plan of care, and create guidelines for the treatment of infants with torticollis.

SUMMARY: CMT presents as a muscular imbalance. We know from the pediatric and adult literature, whether it is about cerebral palsy or anterior cruciate ligament reconstruction, that muscle imbalances can lead to skeletal changes, postural dysfunction, and impaired movement patterns. These can lead to functional limitations and limitations in participation. CMT, therefore, needs to be addressed. Although this article presents the current evidence and guidelines for treatment, there is still much to be learned regarding disease, optimal intervention, duration of treatment, and timing of follow-up.


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