Objective.
One-third of cases in which fibrosis affects the entire length of the sternocleidomastoid (SCM) muscle, cannot be resolved through physical therapy and require surgery. So far, little is known about the treatment efficacy, dosage of physiotherapy of CMT involves entire SCM muscle. The aim of this study is to investigate the therapeutic effect of intensive inpatient treatment in infants with CMT involving the entire SCM muscle using clinical measurements, ultrasound.
Methods.
Of the 1131 infants who were seen at our outpatient clinic for evaluation of CMT between January 2014 and May 2021, 54 infants (27 boys and 27 girls; mean corrected age of 18.57 days) met our inclusion criteria (Figure 1). The inclusion criteria were as follows: (1) involvement of the entire sternocleidomastoid muscle; (2) a sternocleidomastoid muscle thickness >10mm, as measured by ultrasound; (3) age under one month; (4) no previous rehabilitation therapy received prior to participation in this study. Patients were divided into three groups: those who underwent outpatient treatment (Group1), those who received intensive inpatient treatment for 1 week (Group2) and 2 weeks (Group3), respectively. Infants in group 2 and 3 underwent therapeutic exercise followed by ultrasound diathermy with microcurrent two times daily, 1 or 2 weeks respectively. Infants in group 1 underwent outpatient treatment, total 8-12 times. Outpatient treatment consists of manual stretch and ultrasound with microcurrent, two or three times a week. In group 2 and 3, the passive cervical rotational range of motion (PCRROM) of the affected side was evaluated at pre-treatment and at post-treatment. In group 1, PCRROM was measured at pre-treatment and at one month post-treatment. In addition, SCM thickness of affected and unaffected side using ultrasound was evaluated at pre-treatment and at 3 months post-treatment.
Results.
There was no significance difference in demographic data at baseline among 3 groups (Table 1). Both SCM thickness and PCRROM significantly decreased/increased post-treatment compared with that at pre-treatment in three groups (p<.05, Table 2). The mean change of PCRROM was significantly greater in group 3 (16.33° ± 5.50°) than that in group1 (6.00° ± 3.43°) and group 2 (9.55° ± 2.13°) (p<.05, Table 2). In addition, the mean change of PCRROM was significantly greater in group 2 (9.55 ± 2.13) than that in group 1 (6.00 ± 3.43) (p<.05, Table 2). In group 2 (-3.18 ± 2.10) and group 3 (-3.60 ± 2.21), the mean reduction of SCM thickness between at pre-treatment and at 3month post treatment revealed to be significantly greater than that in group 1 (-1.55 ± 1.28) (p<.05, Table 2).
Conclusion.
The present study showed that intensive inpatient treatment may increase the efficacy of therapeutic exercise, ultrasound with microcurrent for the treatment of CMT involving the entire SCM muscle.
|
