Postsurgical Physical Therapy Management of Congenital Muscular Torticollis.

Abstract

To present 2 cases with severe congenital muscular torticollis and describe postsurgical physical therapy management. Two children diagnosed with severe congenital muscular torticollis underwent surgical release of the involved sternocleidomastoid muscle with subsequent physical therapy. Presurgical examination findings, surgical technique, and postsurgical rehabilitation guidelines are described. Both cases achieved full range of motion and symmetrical muscle strength. Functionally, they were able to maintain consistent midline posture, perform transitions with symmetrical head righting, and demonstrate age-appropriate motor skills. Children with surgical management of congenital muscular torticollis tend to have more severe involvement of the sternocleidomastoid. Prolonged experience in atypical postures may result in potential asymmetrical development of visual, vestibular, and proprioceptive systems. Perception of midline was reestablished through integration of visual, vestibular, and proprioceptive stimuli. For more insights from the authors, access Supplemental Digital Content 1, at http://links.lww.com/PPT/A141.