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Diagnostics (Basel). 2019 Oct 23;9(4). pii: E158. doi: 10.3390/diagnostics9040158.

Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis.

Author information

1
Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Korea. dmcddm@cnuh.co.kr.
2
Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Korea. elarien@cnuh.co.kr.
3
Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Korea. jaychoi3399@gmail.com.
4
Daejeon Chungcheong Regional Medical Rehabilitation Center, Chungnam National University Hospital, Daejeon 35015, Korea. jaychoi3399@gmail.com.
5
Department of Rehabilitation Medicine, Hallym University Medical, Center Dongtan Hospital, Hwaseong 18450, Korea. werch@hallym.or.kr.
6
Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Korea. ssyang74@cnu.ac.kr.
7
Daejeon Chungcheong Regional Medical Rehabilitation Center, Chungnam National University Hospital, Daejeon 35015, Korea. ssyang74@cnu.ac.kr.

Abstract

Congenital muscular torticollis (CMT) results from unilateral shortening of the sternocleidomastoid (SCM) muscle, usually associated with a fibrotic mass. Although CMT may resolve with physical therapy, some cases persist, resulting in long-term musculoskeletal problems. It is therefore helpful to be able to monitor and predict the outcomes of physical therapy. Shear-wave velocity (SWV) determined by acoustic radiation force impulse (ARFI) elastography can provide a quantitative measure of muscle stiffness. We therefore measured SCM SWV in 22 infants with unilateral CMT before and after 3 months of physical therapy and evaluated the relationships between SWV and SCM thickness and various clinical features, including cervical range of motion (ROM). SWV was initially higher and the ROM was smaller in affected muscles before physical therapy. SWV decreased significantly (2.33 ± 0.47 to 1.56 ± 0.63 m/s, p < 0.001), indicating reduced stiffness, and muscle thickness also decreased after physical therapy (15.64 ± 5.24 to 11.36 ± 5.71 mm, p < 0.001), both in line with increased neck ROM of rotation (64.77 ± 18.87 to 87.27 ± 6.31°, p < 0.001) and lateral flexion (37.50 ± 11.31 to 53.64 ± 9.41°, p < 0.001). However, the improved ROM more closely reflected the changes in SWV than in muscle thickness. These results suggest that a change in SWV detected by ARFI elastography could help to predict improvements in clinical outcomes, such as stiffness-related loss of motion, in patients with CMT undergoing physical therapy.

KEYWORDS:

acoustic radiation force impulse; cervical range of motion; congenital muscular torticollis; shear wave velocity; ultrasonography

PMID:
31652674
DOI:
10.3390/diagnostics9040158
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Conflict of interest statement

The authors declare that they have no conflicts of interest.

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