Assessment and management of torticollis in infancy: A survey of current physiotherapy practice

Article type: Research Article

Authors: Seager, Anthea

Affiliations: Department of Physiotherapy, Temple Street Children’s University Hospital, Dublin, Ireland. Tel.: +353 01 8784563; E-mail: anthea.seager@cuh.ie.

Abstract: BACKGROUND: Torticollis in infancy is frequently managed by physiotherapists working in paediatrics. However, the assessment and physiotherapy treatment of torticollis in infancy has not been reported adequately in the literature. OBJECTIVES: To explore the assessment and management of infants with torticollis by physiotherapists in Ireland. METHODS: An online survey was conducted among members of the Irish Society of Chartered Physiotherapists’ clinical interest/employment groups, specifically: Chartered Physiotherapists in Community Care; Chartered Physiotherapists in Paediatrics; Chartered Physiotherapists in Private Practice; and Chartered Physiotherapists in Women’s Health and Continence. RESULTS: Sixty-seven physiotherapists completed the survey. There was a high level of agreement amongst physiotherapists regarding what subjective information is sought at initial assessment. However, there was less agreement on the nature of the objective assessment. There was a high level of agreement in the use of assessment techniques for both cervical spine range of motion and posture, with the vast majority of respondents using visual estimation for both. The most common treatment techniques used are positioning, handling and neurodevelopmental facilitation. CONCLUSIONS: This study explored the physiotherapy assessment and management of torticollis in infancy in Ireland. This survey identified that there was a lack of consensus on the objective examination used with infants. It is recommended that physiotherapists include screening for fine motor and hip asymmetries in their assessments and that a pathway of care is developed including access to further specialists and investigations.

Keywords: Congenital Muscular Torticollis, Postural Torticollis, physiotherapy, assessment, management

DOI: 10.3233/PPR-160087

Journal: Physiotherapy Practice and Research, vol. 38, no. 1, pp. 59-66, 2017