Congenital Muscular Torticollis Physical Therapy Guideline Evidence Base

https://journals.lww.com/pedpt/pages/default.aspx
LITTLE ROCK, AR—Emily Heidenreich PT DPT PCS, from Arkansas Children's Hospital in Little Rock, talks about her publication in Pediatric Physical Therapy: "Informing the Update to the Physical Therapy Management of Congenital Muscular Torticollis Evidence-Based Clinical Practice Guideline" (Pediatr Phys Ther 2018;00:1–12) in which her group surveyed the available studies looking at the effectiveness of diagnosis, prognosis and intervention for congenital muscular torticollis. She talks about the evidence base of therapy for this common but curable condition and describes how these data are being used to help generate the updated guideline to ensure it incorporates the latest clinical experience and study data.
STUDY TITLE:
Informing the Update to the Physical Therapy Management of Congenital Muscular Torticollis Evidence-Based Clinical Practice Guideline
AUTHORS:
Emily Heidenreich, PT, DPT PCS; Robert Johnson, MLIS; Barbara Sargent, PT, PhD, PCS . Division of Pediatric Rehabilitation Medicine (Dr Heidenreich), Children’s Hospital Los Angeles, Los Angeles, California; Division of Biokinesiology and Physical Therapy (Drs Heidenreich and Sargent), Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California; Norris Medical Library (Mr Johnson), University of Southern California, Los Angeles, California.
PURPOSE:
To systematically review the recent evidence on physical therapy (PT) diagnosis, prognosis, and intervention of congenital muscular torticollis to inform the update to the PT management of congenital muscular torticollis evidence-based clinical practice guideline.Methods: From 2012 to 2017, 7 databases were searched for studies that informed PT diagnosis, prognosis, or intervention of infants and children with congenital muscular torticollis. Studies were appraised for risk of bias and quality.
Results: Twenty studies were included. No studies informed PT diagnosis. Fourteen studies informed prognosis, including factors associated with presence of a sternocleidomastoid lesion, extent of symptom resolution, treatment duration, adherence to intervention, cervical spine outcomes, and motor outcome. Six studies informed intervention including stretching frequency, microcurrent, kinesiology tape, group therapy, and postoperative PT.
CONCLUSIONS:
New evidence supports that low birth weight, breech presentation, and motor asymmetry are prognostic factors associated with longer treatment duration. Higher-level evidence is emerging for microcurrent intervention. (Pediatr Phys Ther 2018;00:1–12)

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