Saturday, September 15, 2012

Two Approaches To Pediatric Muscular Torticollis


Two Approaches To Muscular Torticollis [Case Report]

Smith-Nguyen EJ. J Clin Chiropr Pediatr. 2004 Sum;6(2):387-393.
ABSTRACT: Objective: The purpose of this paper is to compare and contrast chiropractic care with physical therapy in the management of an infant with congenital torticollis. Design: Case study.  Setting: Private practice.  Clinical Features:  An infant, 10 months of age, was diagnosed with congenital torticollis. Physical therapy was prescribed of a period of two months. This therapy initially was effective in correcting the patient’s postural deformity, but after the physical therapy course was concluded, the patient’s symptoms progressively returned over the following three months. At this time, a course of chiropractic care was initiated. The patient received five chiropractic adjustments over a period of six weeks and the torticollis resolved without returning. Intervention and Outcome: Physical therapy was prescribed by the infant’s pediatrician at 10 months of age. The course of physical therapy included neuromuscular evaluation and recommendation for home exercises to aid in stretching and strengthening the cervical musculature and increasing cervical range of motion. This type of therapy was deemed effective initially but upon release, after two months of therapy, symptoms gradually began returning.  Three months later, the child’s mother sought a chiropractic evaluation, as a second opinion. At this time the patient’s torticollis had returned. In addition, plagiocephaly and delay in gross motor skills development was evident. After a thorough physical examination and neuromuscular evaluation, it was determined that spinal subluxations were the likely cause of the patient’s torticollis. Chiropractic adjustments were performed using light force activator adjustments and gentle joint mobilization. Five adjusting sessions were performed over a six-week period. Follow-up care over a period of eight months indicated no return of the torticollis.  Conclusion:  The use of different therapies, in the treatment of torticollis, can have similar results, but it is important to look at potential underlying causes in the spine, rather than just the muscular contraction alone, in order to achieve the desired long-term results. Chiropractic care provided permanent resolution of the child’s torticollis, reduction of plagiocephaly and improved development milestones.

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