June 14, 2015
Talking About Torticollis
I’ve seen a lot of referrals these past few weeks for babies with torticollis. I’ve talked about this before in the Yin and Yang of Postural Control. A while ago I posted a clinical tip on my HeartSpace PT Facebook page regarding measuring head position for children with torticollis. I know we’re always looking for reliable and convenient ways to document change in all the populations we work with, and this group is no different. The FB post was very popular, so I am re-posting it here for those of you who may not access Facebook.
Here’s a method for objective measurement of head tilt in children with torticollis:
(Rahlin M, Sarmiento B: Reliability of Still Photography Measuring Habitual Head Deviation From Midline in Infants With Congenital Muscular Torticollis. Ped Phys Ther. 2010; 22: 399-406.)
The baby must be lying in supine looking at the camera. Take a photo by standing directly over the baby, keeping the camera at midline. Measure the angle made by lines drawn through the acromion processes and the lateral corners of the eyes.
If you take the photo on your phone/tablet, you can use the iGonio app to measure the angle and email yourself a copy of the photo with measurement for the digital file!
A very helpful resource is the APTA document regarding Congenital Muscular Torticollis:
Kaplan SL, Coulter C, Fetters L. Physical Therapy Management of Congenital Muscular Torticollis: An Evidence-Based Clinical Practice Guideline. Ped Phys Ther. 2013; 25: 348-94.