Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis
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 b...
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doaj-a45106f742e642cba4ea9cb6edca3c7b2020-11-25T00:13:52ZengMDPI AGDiagnostics2075-44182019-10-019415810.3390/diagnostics9040158diagnostics9040158Changes in Muscle Stiffness in Infants with Congenital Muscular TorticollisDongmin Hwang0Young Ju Shin1Ja Young Choi2Soo Jin Jung3Shin-seung Yang4Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon 35015, KoreaDepartment of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon 35015, KoreaDepartment of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon 35015, KoreaDepartment of Rehabilitation Medicine, Hallym University Medical, Center Dongtan Hospital, Hwaseong 18450, KoreaDepartment of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon 35015, KoreaCongenital 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, <i>p</i> < 0.001), indicating reduced stiffness, and muscle thickness also decreased after physical therapy (15.64 ± 5.24 to 11.36 ± 5.71 mm, <i>p</i> < 0.001), both in line with increased neck ROM of rotation (64.77 ± 18.87 to 87.27 ± 6.31°, <i>p</i> < 0.001) and lateral flexion (37.50 ± 11.31 to 53.64 ± 9.41°, <i>p</i> < 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.https://www.mdpi.com/2075-4418/9/4/158congenital muscular torticollisultrasonographyacoustic radiation force impulseshear wave velocitycervical range of motion |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dongmin Hwang Young Ju Shin Ja Young Choi Soo Jin Jung Shin-seung Yang |
spellingShingle |
Dongmin Hwang Young Ju Shin Ja Young Choi Soo Jin Jung Shin-seung Yang Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis Diagnostics congenital muscular torticollis ultrasonography acoustic radiation force impulse shear wave velocity cervical range of motion |
author_facet |
Dongmin Hwang Young Ju Shin Ja Young Choi Soo Jin Jung Shin-seung Yang |
author_sort |
Dongmin Hwang |
title |
Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis |
title_short |
Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis |
title_full |
Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis |
title_fullStr |
Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis |
title_full_unstemmed |
Changes in Muscle Stiffness in Infants with Congenital Muscular Torticollis |
title_sort |
changes in muscle stiffness in infants with congenital muscular torticollis |
publisher |
MDPI AG |
series |
Diagnostics |
issn |
2075-4418 |
publishDate |
2019-10-01 |
description |
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, <i>p</i> < 0.001), indicating reduced stiffness, and muscle thickness also decreased after physical therapy (15.64 ± 5.24 to 11.36 ± 5.71 mm, <i>p</i> < 0.001), both in line with increased neck ROM of rotation (64.77 ± 18.87 to 87.27 ± 6.31°, <i>p</i> < 0.001) and lateral flexion (37.50 ± 11.31 to 53.64 ± 9.41°, <i>p</i> < 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. |
topic |
congenital muscular torticollis ultrasonography acoustic radiation force impulse shear wave velocity cervical range of motion |
url |
https://www.mdpi.com/2075-4418/9/4/158 |
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