Hautopp Lena, Wester Susanne, Bang Birgitte, Buus Lise, Grindsted Jette, Christensen Karen, Knudsen Birgit, Vinther Anders
Æblevangen 68, 2765 Smørum, Denmark.
Dan Med J. 2014 Dec;61(12):A4970.
The incidence of torticollis, which is often accompanied by some degree of plagiocephaly in infants, has remained increased since the introduction of the supine sleeping position to prevent sudden infant death. Recently, instruments allowing quantitative measurement of torticollis and related pathology have been developed and validated. The aim of the present study was to monitor a cohort of children with torticollis using a standardised protocol including valid and reliable measurements.
A total of 136 infants diagnosed with torticollis and referred to physiotherapeutic treatment in four paediatric departments were included (October 2009-April 2011). Trained and calibrated physiotherapists assessed their cervical range of motion (ROM), cervical muscle function and severity of plagiocephaly prior to and after the treatment period.
The infants' median age was three months at inclusion and seven months at the end of the treatment period that comprised a median of five treatment sessions. Initially, 52% and 54% presented with ROM deficits in rotation and lateral flexion, respectively. After treatment, these parts were reduced to 6% and 14%, and the magnitudes of the remaining ROM deficits were substantially reduced. Plagiocephaly improved in 82, remained unchanged in 18 and deteriorated in five of 105 infants with complete follow-up. Symmetrical or almost symmetrical muscle function was achieved in 93% (n = 101).
A successful outcome was achieved in the majority (90%) of children with torticollis with less than ten physiotherapeutic treatment sessions.
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自采用仰卧睡眠姿势以预防婴儿猝死综合征以来,斜颈的发病率一直呈上升趋势,婴儿斜颈常伴有一定程度的扁头畸形。最近,已开发并验证了能够对斜颈及相关病变进行定量测量的仪器。本研究的目的是使用包括有效且可靠测量方法的标准化方案,对一组斜颈儿童进行监测。
纳入了在四个儿科部门被诊断为斜颈并接受物理治疗的136名婴儿(2009年10月至2011年4月)。经过培训和校准的物理治疗师在治疗期前后评估了他们的颈部活动范围(ROM)、颈部肌肉功能和扁头畸形的严重程度。
纳入时婴儿的中位年龄为3个月,治疗期结束时为7个月,治疗期的中位数为5次治疗。最初,分别有52%和54%的婴儿在旋转和侧屈方面存在ROM缺陷。治疗后,这些比例分别降至6%和14%,其余ROM缺陷的程度也大幅降低。在105名接受完整随访的婴儿中,82名的扁头畸形有所改善,18名保持不变,5名恶化。93%(n = 101)的婴儿实现了对称或几乎对称的肌肉功能。
大多数(90%)斜颈儿童在接受少于十次物理治疗后取得了成功的治疗效果。
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