Analysis of Scales and Physical Therapy Protocols Associated with Congenital Muscular Torticollis: A literature review
DOI:
https://doi.org/10.62827/fb.v27i3.1172Keywords:
Physical Therapy; Rehabilitation; Child Development; Pediatrics.Abstract
Introduction: Congenital muscular torticollis (CMT) is an orthopedic condition with neurological and neurodevelopmental repercussions characterized by unilateral shortening of the sternocleidomastoid muscle (SCM), which may compromise motor development, postural symmetry, and quality of life in infants. Given the diversity of available therapeutic approaches, it becomes essential to analyze the assessment scales and physiotherapeutic protocols most commonly used in the management of this condition. Objective: To analyze the functional implications of CMT and the effects of physiotherapy on the motor development of infants. Methods: Integrative Literature Review, conducted based on a structured protocol using the PRISMA flowchart (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The search was carried out in the PubMed, SciELO, LILACS, and PEDro databases, considering articles published between 2015 and 2025, in Portuguese, English, or Spanish. The selection followed the PRISMA flowchart, with explicit inclusion and exclusion criteria. Structured data extraction into tables. Results: Conservative physiotherapeutic treatment, especially passive manual stretching of the SCM muscle, proved to be the gold standard, with high effectiveness when initiated early. Complementary techniques, such as active mobilizations, postural training, and electrothermophototherapeutic resources, demonstrated potential to optimize clinical outcomes. The Alberta Infant Motor Scale (AIMS) and the Functional Symmetry Observation Scale version 2 (FSOS-V2) proved to be effective and complementary instruments: while the AIMS assesses global motor development, the FSOS-V2 stands out for its sensitivity in detecting subtle functional asymmetries. Conclusion: Physiotherapy plays a fundamental role in the management of CMT, being determinant for the prevention of secondary deformities, promotion of postural symmetry, and improvement of motor development. The combined use of the AIMS and FSOS-V2 scales favors individualized therapeutic planning and precise monitoring of clinical evolution.
References
Rodrigues L, et al. Torcicolo muscular congênito: avaliação e tratamento fisioterapêutico [Congenital muscular torticollis: physiotherapy assessment and treatment]. Revista CPAQV – Centro de Pesquisas Avançadas em Qualidade de Vida. 2021;13(13). Available from: https://revista.cpaqv.org/index.php/CPAQV/article/view/825. DOI: 10.36692/v13n3-14.
Rahlin M, et al. Functional Symmetry Observation Scale, Version 2: development and content validation using a modified Delphi method. Pediatric Physical Therapy [Internet]. 2022;34(1):37-44. [cited 2025 Aug 28]. Available from: https://pubmed.ncbi.nlm.nih.gov/34958331/ DOI: 10.1097/PEP.0000000000000862.
Rodríguez-Huguet M, et al. Effectiveness of the treatment of physiotherapy in congenital muscular torticollis: a systematic review. Children (Basel). 2024;11(1):8. Available from: https://pubmed.ncbi.nlm.nih.gov/38275429/. DOI: 10.3390/children11010008.
Shin YJ, et al. Alterações na rigidez muscular em bebês com torcicolo muscular congênito [Changes in muscle stiffness in infants with congenital muscular torticollis]. Diagnostics. 2019;9(4):158. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6963363/. DOI: 10.3390/diagnostics9040158.
Poole C, et al. A eficácia do alongamento para bebês com torcicolo muscular congênito [The effectiveness of stretching for infants with congenital muscular torticollis]. Physical Therapy Reviews [Internet]. 2019;24(1-2). [cited 2025 Aug 24]. Available from: https://research-portal.uea.ac.uk/en/publications/the-effectiveness-of-stretching-for-infants-with-congenital-muscu/ DOI: 10.1080/10833196.2019.1570704.
Bastos S, et al. Torcicolo muscular congênito [Congenital muscular torticollis]. Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação [Internet]. 2014;25(1):20-25. [cited 2025 Oct 2]. Available from: https://spmfrjournal.org/index.php/spmfr/article/view/128. DOI: https://doi.org/10.25759/spmfr.128.
Song, et al. Effect of physical therapy intervention on thickness and ratio of the sternocleidomastoid muscle and head rotation angle in infants with congenital muscular torticollis: a randomized clinical trial (CONSORT). Medicina. 2021;100(33). Available from: https://pubmed.ncbi.nlm.nih.gov/34414985/. DOI: 10.1097/MD.0000000000026998.
Kwon DR, et al. Eficácia da terapia intensiva hospitalar em lactentes com torcicolo muscular congênito envolvendo todo o músculo esternocleidomastóideo [Efficacy of inpatient intensive care for infants with congenital muscular torticollis involving the entire sternocleidomastoid muscle]. Children [Internet]. 2023;10(6):1088. [cited 2025 Oct 21]. Available from: https://www.mdpi.com/2227-9067/10/6/1088. DOI: 10.3390/children10061088.
Araujo LCO, et al. Fisioterapia no torcicolo muscular congênito na adolescência: um estudo de caso [Physical Therapy for Congenital Muscular Torticollis in Adolescents: A Case Study]. Revista Ibero-Americana de Humanidades, Ciências e Educação. 2025;11(7):1567-76. [cited 2025 Nov 18]. Available from: https: https://periodicorease.pro.br/rease/article/view/20326. DOI: https://doi.org/10.51891/rease.v11i7.20326
Ribas CG, et al. Torcicolo congênito: evidências no tratamento fisioterapêutico [Congenital torticollis: evidence for physical therapy treatment]. Revista Científica Sistemática [Internet]. 2024;14(4). [cited 2025 Nov 1]. Available from: https://sevenpubl.com.br/RCS/article/view/5463. DOI: 10.56238/rcsv14n4-014.
Felix AM, et al. Tratamento cirúrgico do torcicolo congênito inveterado [Surgical treatment of intractable congenital torticollis]. HSPE Técnicas em Ortopedia [Internet]. 2020;20(4):12-16. [cited 2025 Nov 18]. Available from: https://rto.emnuvens.com.br/revista/article/view/131.
Hoiness PR, et al. Surgical treatment of congenital muscular torticollis: significant improvement in health-related quality of life among a 2-year follow-up cohort of children, adolescents, and young adults. Journal of Pediatric Orthopaedics [Internet]. 2023;43(9):e769-e776. [cited 2025 Oct 17]. Available from: https://pubmed.ncbi.nlm.nih.gov/37493035/. DOI: 10.1097/BPO.0000000000002480.
Rahlin M, Barnett J, Sarmiento B. Functional Symmetry Observation Scale Version 2: development and content validation using a modified Delphi method. Pediatr Phys Ther. 2021. [cited 2025 Dec 17]. Available from: https://pubmed.ncbi.nlm.nih.gov/34958331/. DOI: 10.1097/PEP.0000000000000847.
Saccani R, Valentini NC. Reference curves for the Brazilian Alberta Infant Motor Scale: percentiles for clinical description and follow-up over time. Jornal de Pediatria (Rio J). 2012;88(1):40-47. Available from: https://www.jped.com.br/en-download-pdf-X2255553612011010. DOI: 10.2223/JPED.2142.
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Copyright (c) 2026 Juliana Yumi Mori Saiki, Larissa de Menezes Silva, Giovanna Alves, Lara Sabrina Silva, Thifany Pereira Benitez, Giovanna Apolinário da Silva, Uerley Magalhães Franchi (Autor)
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