Physical Therapy Management of Congenital Muscular Torticollis

Congenital muscular torticollis (CMT) is an idiopathic postural deformity detectable shortly after birth, usually characterized by lateral flexion of the head to one side and cervical rotation to the opposite side as a result of unilateral shortening of the sternocleidomastoid muscle. CMT may be accompanied by other neurological or musculoskeletal conditions. Infants with CMT are often referred to physical therapists (PTs) to treat their asymmetries. This evidence-based clinical practice guideline (CPG) provides guidance on which infants should be monitored, treated, and/or referred, and when and what PTs should treat. Based upon critical appraisal of literature and expert opinion, 16 action statements for screening, examination, intervention, and follow-up are linked with explicit levels of evidence. The CPG addresses referral, screening, examination and evaluation, prognosis, first-choice and supplemental interventions, consultation, discharge, follow-up, recommendations for implementation and compliance audits, flow sheets for referral paths and classification of CMT severity, and research recommendations.