Cervical Lateral Flexion Stretching Angles Applied During Physical Therapy in Infants With Congenital Muscular Torticollis: A Video-Based Observational Study
- 1Department of Physical Medicine and Rehabilitation, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
Abstract
Objective: To quantify the cervical lateral flexion stretching angles attained and tolerated during routine physical therapy in infants aged 12 months or younger with congenital muscular torticollis (CMT), and to compare them between two therapeutic positions and across age groups.
Methods: Infants with CMT were recorded once, at the first physical therapy session after diagnosis. Therapists stretched in both directions in supported forward-facing and supine positions. Angles were computed from video frames between the inter-pupillary and inter-glenohumeral vectors; the direction of flexion was determined visually from the recordings. The primary analysis used the therapeutic direction, lateral flexion away from the head tilt.
Results: Eighty-two infants were analyzed. In the therapeutic direction the angle was greater in the supported forward-facing position (41.9±8.0°, n=79) than supine (31.7±9.1°, n=54); among 51 infants measured in both, the mean paired difference was 10.8° (95% confidence interval, 8.1–13.5; p<0.001; Cohen’s d=1.12). In exploratory comparisons, no difference was detected between the therapeutic and opposite directions (p=0.39, p=0.73) or across age groups (p>0.05). Inter-rater reliability of annotation was high (intraclass correlation coefficient, 0.98).
Conclusion: A greater lateral flexion angle was attained in the supported forward-facing position than supine; exploratory analyses detected no difference across age groups or between stretching directions. These findings provide descriptive values for therapist-applied stretching in this cohort; their relationship with clinical outcomes and safety requires further study.
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BibTeX
@article{kim2026cervical,
title = {{Cervical Lateral Flexion Stretching Angles Applied During Physical Therapy in Infants With Congenital Muscular Torticollis: A Video-Based Observational Study}},
author = {Bumcheol Kim and Jeon-Woong Kang and Dae-Hyun Jang and Jaewon Kim},
journal = {Annals of Rehabilitation Medicine},
year = {2026},
month = oct,
doi = {10.5535/arm.260098},
url = {https://doi.org/10.5535/arm.260098},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Cervical Lateral Flexion Stretching Angles Applied During Physical Therapy in Infants With Congenital Muscular Torticollis: A Video-Based Observational Study
AU - Bumcheol Kim
AU - Jeon-Woong Kang
AU - Dae-Hyun Jang
AU - Jaewon Kim
PY - 2026
DA - 2026/10/29
JO - Annals of Rehabilitation Medicine
DO - 10.5535/arm.260098
UR - https://doi.org/10.5535/arm.260098
AB - Objective: To quantify the cervical lateral flexion stretching angles attained and tolerated during routine physical therapy in infants aged 12 months or younger with congenital muscular torticollis (CMT), and to compare them between two therapeutic positions and across age groups. Methods: Infants with CMT were recorded once, at the first physical therapy session after diagnosis. Therapists stretched in both directions in supported forward-facing and supine positions. Angles were computed from video frames between the inter-pupillary and inter-glenohumeral vectors; the direction of flexion was determined visually from the recordings. The primary analysis used the therapeutic direction, lateral flexion away from the head tilt. Results: Eighty-two infants were analyzed. In the therapeutic direction the angle was greater in the supported forward-facing position (41.9±8.0°, n=79) than supine (31.7±9.1°, n=54); among 51 infants measured in both, the mean paired difference was 10.8° (95% confidence interval, 8.1–13.5; p<0.001; Cohen’s d=1.12). In exploratory comparisons, no difference was detected between the therapeutic and opposite directions (p=0.39, p=0.73) or across age groups (p>0.05). Inter-rater reliability of annotation was high (intraclass correlation coefficient, 0.98). Conclusion: A greater lateral flexion angle was attained in the supported forward-facing position than supine; exploratory analyses detected no difference across age groups or between stretching directions. These findings provide descriptive values for therapist-applied stretching in this cohort; their relationship with clinical outcomes and safety requires further study.
SN - 2234-0645
SN - 2234-0653
ER -