. Author manuscript; available in PMC: 2021 Jul 28.

Published in final edited form as: Pediatr Phys Ther. 2018 Jul;30(3):164–175. doi: 10.1097/PEP.0000000000000517

Table 5.

Intervention Evidence

Author & Year	Level of Evidence	Study Design	Participants	N=	Experimental vs. Comparison Groups	Intervention	Home Program	Outcomes (measurement tool)	Results (between group differences)	Clinical Implications
Giray et al 2016²⁷	Level II	RCT	CMT, 3–12 mo	33	(1) EX+ inhibitory KT on involved SCM (n=12) (2) EX+ inhibitory KT on involved SCM + facilitation KT on uninvolved SCM (n=10) (3) EX Only (n=11)	30 min EX (ROM; stretching affected SCM 3×15 reps [ROT & LAT FLEX], 1 sec hold with 5–10 sec rest; strengthening unaffected SCM; handling strategies; ball ex) 2x/wk for 3 wks; KT applied after EX as per group assignment	Parents instructed on how to perform Intervention; performed 3x/day during 3 mo follow up period	ROT & LAT FLEX PROM (AP), LAT FLEX Strength (MFS), Craniofacial asymmetry (SSAP)	ROT: NS LAT FLEX: NS STRENGTH: NS CRANIOFACIAL: NS	KT provided no added benefit to PT intervention
He et al 2016²⁵	Level II	RCT	CMT< 3 mo, limited cervical ROM	50	(1) 50x stretching (n=24) (2) 100x stretching (n=26)	5–10 day training then parents implemented at home: 10 rot and lat flex stretches, 10–15 sec hold, 5 or 10 x/day as per group assignment	Same as Intervention	ROT & LAT FLEX PROM (AP), Head Tilt (AP), LAT FLEX Strength (MFS), SCM Muscle Thickness (US)	ROT: 100x group greater improvement at 1 and 2 mo post-tx (P < 0.05) LAT FLEX/HEAD TILT: 100x group greater improvement at 1 and 2 mo post-tx (P < 0.05) STRENGTH: NS SCM Thickness: NS	Increased frequency of daily stretching resulted in decreased head tilt and increased ROT & LAT FLEX PROM
Kwon and Park 2014²⁶	Level II	RCT	CMT < 3 mo with entire SCM involvement, palpable SCM mass	20	(1) EX + US + Microcurrent on (n=10) (2) EX + US + Microcurrent off (n=10)	3 x/ wk; US diathermy 5 min + EX (ROM, postural training, manual SCM stretching [3 × 15 reps, 1 sec hold, 5–10 sec rest]) 20 min + Microcurrent 30min (on/off)	ROT & LAT FLEX stretches, 10x/session, 6x/day; Positioning and handling to promote ROT towards affected SCM	ROT PROM (AP); SCM thickness, CSA & red pixel intensity (SE); tx duration	ROT: 1,2,3 mo post-tx was significantly greater in microcurrent group vs. control; NS at 6 mo SCM thickness, CSA, red pixel intensity: 3 mo post-tx significant differences in microcurrent group vs. control Tx duration: shorter in microcurrent group (2.6 mo) compared to control (6.3 mo)	The addition of microcurrent resulted in shorter tx duration
Ohman et al 2015²⁸	Level II	RCT	CMT ≤12 mo with LAT FLEX muscle imbalance	29	(1) Inhibitory KT on involved SCM (n=16) (2) No KT (n=13)	KT muscle relaxation technique to involved SCM; No EX	None	LAT FLEX Strength (MFS)	STRENGTH: Significant difference between groups with KT applied (P < .0001); Significantly lower scores on the involved side with KT (P < .0001) & significantly higher scores on the uninvolved side after taping (P= .01)	KT for muscle relaxation resulted in improved LAT FLEX AROM against gravity

Abbreviations: AP= arthrodial protractor, CMT = congenital muscular torticollis, CSA = cross sectional area, EX = exercise, KT = kinesiology taping, LAT FLEX= cervical lateral flexion, MFS = Muscle Function Score, min = minute, mo= month, NS = not significant (p>.05), (A/P)ROM = (active/passive) range of motion, RCT = randomized control trial, reps = repetitions, ROT= cervical rotation, SCM = sternocleidomastoid muscle, SE= sonoelastography, sec = seconds, SSAP = severity scale for assessment of plagiocephaly, tx = treatment, US = ultrasound, wk = week, x = times, + = plus, / = per