Congenital Muscular Torticollis Clinical Trial
Official title:
Longitudinal Follow-up of Muscle Echotextures in Infants With Congenital Muscular Torticollis
Objective: To document the sternocleidomastoid (SCM) muscle fibrosis in congenital muscular
torticollis (CMT) infants with quantified echotexture and measured thickness during the
treatment course.
Design: Cohort study. Setting: Rehabilitation department in a tertiary care hospital.
Participants: Infants with clinical diagnosis of CMT, without any neurological presentation,
cervical spin abnormality, and developmental dysplastic hip problem, were recruited in the
study.
Intervention: All subjects had physiotherapy for at least 3 months. They underwent at least
two times of clinical assessment and ultrasonographic examination (1) for bilateral SCM
muscles during the follow-up period.
End of follow-up: Subjects who still had prominent clinical presentations after
physiotherapy for 6 months or were older than 1 year would receive surgery. Subsided
presenting clinical features determined by the clinician was the other end-point of this
investigation.
Main Outcome Measures: The K value, derived from the difference of echo intensities (2)
between the involved and uninvolved SCM muscles on longitudinal sonograms, was used to
represent the severity of muscle fibrosis in CMT infants. Bilateral SCM muscle thickness and
involved-to-uninvolved thickness ratio (Ratio I/U) were also obtained from longitudinal
sonograms. Clinical outcome was also recorded.
1. An experienced sonographer performed ultrasonographic examination with the subject in
the supine position and heads rotated contralaterally to the examination side. A 5-12
MHz linear-array ultrasound transducer was used to observe both longitudinal and
transverse views of bilateral SCM muscles for each subject. The ultrasound system
settings, including gain (86%), monitor dynamic range (70 dB), and depth (2 cm), were
kept constant throughout the study.
2. The echo intensity was determined by computer-assisted gray scale analysis and was
calculated in MATLAB 2006b. The mean echo intensity of every pixel in the region of
interest and the K value developed to compare sonograms between different individuals
or between different times in the same subject were estimated as the previous study
(PMID: 22215768)
;
Observational Model: Cohort, Time Perspective: Prospective
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