Konjenital Muskuler Tortikollis ve Ilişkili Deformasyonel Plagiosefalide Ev Programı ve Fizyoterapi Programının Kontrol Sıklığı Açısından Etkinliğinin Karşılaştırılması

Abstract

Purpose: Comparison the effectiveness control frequency of home program and physiotherapy on congenital muscular torticollis and deformational plagiocephaly. Method: Babies with congenital muscular torticollis, aged between 0-6 months, who had a head tilt from 5 to 20 degrees and no other health problems were the participants of the study. The study included three groups; first home program group was seen once every six weeks, second home program group was seen once a week, the third group in addition to the home program also received soft tissue mobilization three times in a week. All groups received a baseline home program consisting of positioning, handling strategies plus stretching, stretching and strengthening exercises, environmental adaptations and classical massage. Babies were allocated to three groups by sealed envelope randomization. Babies were evaluated initially, at sixth weeks, at 12 weeks and follow-up at 18 weeks with muscle function scale, head tilt and plagioceplalometric assessments which included photographing method, neck normal range of motions (lateral flexion and rotation) and plagiocephaly severity scale. Results: All groups showed significant improvements in time dependent analyses (p<.05); head tilt and severity of plagiocephaly decreased; neck range of movements and symmetrical posture of head increased. Pair wise analyses of three groups showed that there were differences at six weeks in favor of the soft tissue mobilization group and second home program group; soft tissue mobilization group showed better results. At 12 weeks there were no differences between groups in congenital muscular torticollis parameters but there were differences in plagiocephalometric results in favor of soft tissue mobilization group and second home program group. When compared to the weekly controlled home program group the soft tissue mobilization group had better results. At follow up there were differences in plagioceplalic evaluations. Soft tissue mobilization showed better results. Conclusion: The results of the study showed that home programs (with intermittent or weekly controls) and soft tissue mobilization are effective methods in managing congenital muscular torticollis and secondary deformational plagiocephaly. The study also showed that frequent controls and soft tissue mobilization provided better results in short time outcomes both for congenital muscular torticollis and plagiocephaly for later outcomes of plagiocephaly.