Clinical Study On The Treatment Of Non-mass Congenital Muscular Torticollis By Rotating And Stretching Method Combined With Neck Functional Exercise

Objective: To observe the curative effect of cervical extension and axial rotation tuina combined with neck function exercise on non-mass congenital muscular torticollis through randomized controlled trials,and compared with conventional tuina operation,in order to provide new clinical treatment of non-mass congenital muscular torticollis.Methods: According to the cluster design,64 children who met the inclusion criteria were randomly divided into a treatment group and a control group,with 32 cases in each group.The treatment group was treated with cervical extension and axial rotation method combined with neck functional exercise,while the control group was treated with conventional tuina,treatment 4 times a week,a total of 12 weeks.Before and after treatment,the range of neck movement such as head tilt and rotation was recorded,and the surface EMG signals of muscle groups-the sternocleidomastoid muscle,trapezius muscle and C4 paraspinal muscle in the resting state and active state were measured.Then the difference in value before and after treatment was compared.Results: 1.Comparison of the degree of head skew and neck rotation limitation: In two groups after treatment were statistically significant(P < 0.05).After treatment,there was statistically significant difference between two groups in treating the symptom of neck rotation limitation(P<0.05),further more the treatment group was better than the other,but there was no statistically significant difference between two groups in head skew symptom(P>0.05).2.Comparison of RMS difference of surface EMG on healthy and affected side: Intra-group comparison,the two groups had significant difference in reducing the value between healthy and affected side of the three muscle groups(P < 0.05).The RMS difference before and after treatment between two groups was statistically significant(P < 0.05)in the sternocleidomastoid and trapezius muscle groups,but there was significantly difference in the C4 paraspinal muscles(P > 0.05),and the numerical value between the treatment group was visibly lower than the control group.3.Comparison of therapeutic efficacy: The total effective rate of the treatment group was 96.8%,and the control group was 83.3%,the cure rates were 45.2% and23.3% separately.There was a statistical difference between two groups(P<0.05),cure rate of the treatment group was higher than the control group as well.Conclusion: Compared with the conventional tuina operation,the method of cervical extension and axial rotation tuina combined with neck functional exercise has obvious advantages in increasing the cervical rotation angle and correcting imbalances of muscle strength,especially in imbalance of the posterior cervical muscle groups.This treatment of non-mass congenital muscular torticollis can achieve a more stable curative effect,which is safe,convenient and worthy of popularization and application.