Conservative management of congenital muscular torticollis: an evidence-based algorithm and preliminary treatment parameter recommendations.

PURPOSE: To present an algorithm with accompanying treatment parameters for the management of congenital muscular torticollis (CMT) based on the best available literature.

METHODS

A systematic search of PubMed, MEDLINE, CINHAL, and Cochrane databases was conducted to identify evidence to guide the conservative management of CMT.

RESULTS

An evidence-based algorithm was created based on three prognostic factors that influence treatment duration and outcome, including a sternocleidomastoid fibrotic mass, passive range of motion rotation deficit, and age at initiation of treatment. Preliminary treatment parameter recommendations for clinic and home programming accompany the algorithm.

CONCLUSION

Use of the proposed evidence-based algorithm with accompanying preliminary treatment parameter recommendations may improve consistency of care and outcomes for infants with CMT. While a higher level of evidence supports the three prognostic factors utilized in the algorithm, research gaps continue to exist with regards to treatment parameters.