Table 4.

Prognostic Evidence for Treatment Duration

Author & Year	Study Design	Participants	N=	Outcome	Treatment	Statistics	Results: Significant Prognostic Factors	Results: Non-Significant Prognostic Factors	Clinical Implications
Han et al 201711	Retrospective Cohort	CMT	182	Full neck PROM and no tilt	SCM lesion- manual stretching for ROT and LAT FLEX & active strengthening; 2–3x/wk No lesion- manual stretching into LAT FLEX & strengthening with postural reactions; 2–3x/wk	Chi Squared; T-test	Shorter tx for nonlesion group	Sex, method of delivery, gestational age, DDH, birth weight	Longer tx duration associated with presence of SCM lesion
Hong et al 201616	Retrospective Cohort	CMT < 3 mo, palpable neck mass	53	LAT FLEX and ROT < 5° difference side-to-side	Manual stretching and SCM massage 2x/wk for 30 min + HEP	Spearman correlation coefficient	Strain Ratio	SCM muscle thickness, SCM thickness ratio	Longer tx duration associated with increased SCM stiffness
Jung et al 201519	Cohort	CMT	118	LAT FLEX and ROT ROM <5° difference side-to-side	2 x/wk for 30 min of LAT FLEX and ROT PROM + HEP of PROM and active EX	Pearson correlation	Fetal presentation, age at diagnosis, birth weight, SCM thickness, SCM thickness ratio	Sex, involved side, methods of delivery, DDH, facial asymmetry, DP, gestational age, LAT FLEX and ROT PROM	Longer tx duration associated with breech fetal presentation, younger age at diagnosis, lower body weight, thicker SCM, and higher SCM thickness ratio
Lee et al 201518	Cohort	CMT<6m with palpable neck mass or limited ROT PROM	102	Not reported	3x/week for 30 min therapeutic US, manual stretching, massage, and passive stretching	Pearson Correlation Coefficient	preDifference in SCM thickness, preHead Tilt, preTOA, change in SCM thickness, change in Head Tilt, change in TOA	None	Longer tx duration associated with increased SCM thickness, increased head tilt, and lower TOA scores
Lee et al 201617	Retrospective Cohort/Case Control	CMT≤ 6 mo with ROT and LAT FLEX ROM limitation >10°, completed OP PT	149	Tx duration: ROT & LAT FLEX ≤ 5° difference or did not respond after 6 mo tx or at 12 mo of age; measured monthly	Manual stretching 30 minutes 3x/wk: flexion, rotation, lateral flexion, and extension 3 × 15 reps for 1 sec with 10 second rest between; Active symmetric neck positioning at home without stretching	Pearson Correlation Coefficient; ANCOVA	Adjusted for age at presentation and initial ROT & LAT FLEX PROM limitation, duration shorter in US normal	None	Shorter tx duration associated with US normal group when adjusted for initial ROT, LAT FLEX and age at presentation
Watemberg et al 201620	Retrospective Cohort	Infants with congenital postural torticollis	173	Functional motor asymmetry as assessed by reduced volitional motor activity of one or both limbs on one side with no weakness or spasticity	None	Chi squared; T-test	Delayed motor development and DP more common in infants with functional asymmetry, significantly longer tx duration in asymmetry	Age of diagnosis, torticollis side, family history, shoulder girdle weakness, axial hypotonia, increased muscle tone	Longer tx duration for infants with congenital postural torticollis and functional motor asymmetry

Abbreviations: ANCOVA= analysis of covariance, CMT = congenital muscular torticollis, DDH= developmental dysplasia of the hip, DP = deformational plagiocephaly, EX = exercise, HEP = home exercise program, LAT FLEX= cervical lateral flexion, min = minute, mo= month, OP= outpatient, (P)ROM = (passive) range of motion, PT= physical therapy, reps = repetitions, ROT= cervical rotation, SCM = sternocleidomastoid muscle, sec = seconds, TOA= Torticollis Overall Assessment, tx = treatment, US = ultrasound, wk = week, x = times, + = plus, / = per