Who is this study for? This study is designed for infants aged 0-6 months who have been diagnosed with Congenital Muscular Torticollis (CMT). CMT is a condition observed at birth or shortly after, characterized by the shortening of the sternocleidomastoid (SCM) muscle, leading to the baby's head tilting to one side and rotating to the opposite side. It affects both boys and girls and may result in limited neck movement, abnormal posture, facial asymmetry, and potential developmental delays if left untreated.
What is the purpose of this study? The goal of this study is to compare the effectiveness of two different physical therapy methods-face-to-face rehabilitation and telerehabilitation-in treating infants with CMT. In addition to evaluating the outcomes of these two therapy methods, this research also aims to provide families with reliable, accessible information through a web-based educational platform.
Why is this study important? Early diagnosis and intervention are crucial for optimal recovery in infants with CMT. Studies show that infants who begin therapy by one month of age have up to a 98% chance of full recovery. However, if diagnosis and treatment are delayed, the recovery process can take longer and may be less effective. This study will help determine if online (telerehabilitation) sessions can be just as effective as traditional face-to-face therapy, offering a flexible and accessible treatment option for families.
What are the benefits of participating?
* Access to a structured, evidence-based rehabilitation program for your child * Guidance from trained pediatric physiotherapists * Increased awareness and knowledge about CMT through a web-based family education platform * Contribution to research that may benefit other children and families in the future * Evaluation of your baby's progress through professional assessments
What will the therapy program involve?
Participants will be randomly assigned to either a face-to-face or telerehabilitation group. Both groups will follow the same therapy program, focusing on:
* Increasing passive and active neck movements * Promoting symmetrical head and body movement * Providing recommendations for environmental adjustments * Educating parents or caregivers on home-based exercises and care
Program structure:
* Face-to-face group: Therapy sessions will be conducted in a clinic setting, twice a week for 30 minutes each session, over a period of 8 weeks. * Telerehabilitation group: Therapy sessions will be conducted via Zoom, with the same frequency, duration, and content as the face-to-face sessions.
How will outcomes be measured?
Infants will be assessed before and after the 8-week therapy period for:
* Passive cervical range of motion (rotation and lateral flexion) * Gross motor function * Muscle function Parental adherence to the home program will also be evaluated through a questionnaire. A follow-up will be conducted one month after therapy ends.
How can I participate? If your infant is aged 0-6 months and has been diagnosed with CMT, you may be eligible to participate. You will need access to a device with internet for telerehabilitation sessions, if assigned to that group. Participation is voluntary and free of charge. Families will receive detailed instructions and ongoing support throughout the program.
Additional Resources:
As part of this study, a web-based educational platform will be made available to all participating families. This platform will include:
* Clear explanations about CMT * Instructional videos and home exercise guides * Tips for daily care and positioning * Frequently asked questions (FAQ) for parents Why is this research unique? This is one of the first studies to scientifically compare face-to-face and online rehabilitation for CMT infants, while also providing a reliable online resource for families. It aims to help develop alternative, flexible care models that meet the diverse needs of families and infants.
Contact Information:
If you are interested in participating or would like more information, please contact our research team at:
\[[email protected] / +905534646606\] We are committed to supporting your child's health and development. Thank you for considering being a part of this important study.
Infants aged 0 to 6 months
Diagnosed with congenital muscular torticollis (CMT)
Classified as Grade 1 to 3 CMT severity based on clinical assessment
Plagiocephaly
Ocular torticollis
Neurological complications
Musculoskeletal disorders of the cervical spine
Parallel
face to face rehabilitation
Other interventionThe face-to-face rehabilitation program will be delivered in a clinical setting to infants aged 0-6 months with congenital muscular torticollis (CMT). It is based on neurodevelopmental treatment (NDT) principles and consists of: Passive range of motion (ROM) exercises for the neck Active ROM exercises for the neck and trunk Activities to promote the development of symmetrical movement Environmental modification suggestions for the home setting Parent/caregiver education and training Sessions will be conducted twice per week, 30 minutes per session, over a total of 8 weeks. In addition, an individualized home exercise program will be prescribed for each infant based on their specific needs. Frequency and duration of the home exercises may vary accordingly.
telerehabilitation
Other interventionThe telerehabilitation program provides the same therapeutic content as the face-to-face rehabilitation group but will be delivered remotely via the Zoom video conferencing platform. The program will be applied to infants aged 0-6 months with congenital muscular torticollis (CMT) and is based on neurodevelopmental treatment (NDT) principles, including: Passive range of motion (ROM) exercises for the neck Active ROM exercises for the neck and trunk Activities for symmetrical movement development Environmental modification suggestions Parent/caregiver education and guidance Sessions will be conducted via live video calls, twice per week, 30 minutes per session, for 8 weeks. Each family will also receive an individualized home exercise program, with its frequency and duration adapted to the infant's needs.
Passive Cervical Range of Motion (Lateral Flexion and Rotation)
Passive range of motion (ROM) of the neck, specifically lateral flexion and rotation, will be assessed using an arthrodial goniometer. Measurements will be taken at three time points: Baseline (Pre-intervention) Post-intervention (At the end of 8 weeks of rehabilitation) Follow-up (1 month after the end of the intervention) This outcome aims to evaluate changes in cervical mobility in response to the rehabilitation programs.
Head Tilt Angle (Still Photography Method)
Head tilt will be assessed using the Still Photography Method, a standardized photographic procedure: A photograph of the infant is taken in a supin position. A horizontal line is drawn connecting the pupils of both eyes (inter-pupillary line). A second line is drawn connecting the acromion processes of both shoulders. The acute angle between these two lines is measured to quantify the degree of head tilt. This method allows for an objective and reliable evaluation of head posture asymmetry in infants with congenital muscular torticollis (CMT).
Muscle Function Test (MFT)
The Muscle Function Test (MFT) is a visual assessment tool used to evaluate the infant's head-righting response. The procedure is performed as follows: The infant is held in a vertical position, facing a mirror. The infant is then slowly moved into a horizontal position, toward the side of the shortened sternocleidomastoid (SCM) muscle. The evaluator observes the head and neck righting reaction, focusing on the infant's ability to align the head vertically in response to the positional change. The test is scored on a 6-point scale (0-5) based on the alignment of the head relative to the vertical axis.
Alberta Infant Motor Scale (AIMS)
The Alberta Infant Motor Scale (AIMS) will be used to assess gross motor development in infants. AIMS is a standardized observational assessment tool designed to evaluate motor performance and monitor the effectiveness of early interventions in infants aged 0 to 18 months. The test consists of 58 items and takes approximately 10 minutes to administer. The infant's spontaneous movements are observed in four positions: supine, prone, sitting, and standing, without any physical contact. Each item that the infant successfully performs is scored as 1 point. The total raw score is then converted into a percentile score based on age norms. The percentile rank reflects the infant's motor performance in comparison to age-matched peers. According to the normative chart: Percentiles of 5% or below indicate atypical development. Percentiles below 10% suggest the infant is at risk for motor delay. Scores are categorized as normal, suspicious, or abnormal. The AIMS has demonstrated strong va
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