第十七屆 實證本位服務探討肌肉訓練對於0-12個月大先天性肌性斜頸症嬰幼兒之頸部肌肉功能的影響：系統性回顧

實證本位服務探討肌肉訓練對於0-12個月大先天性肌性斜頸症嬰幼兒之頸部肌肉功能的影響：系統性回顧

Evidence-Based Practice in the Effects of Neck Muscle Functions by Strengthening Exercises for 0-12 Month-Old Infants with Congenital Muscular Torticollis: A Systematic Review

伊薇靜^1*

Wei-Jing I^1*

¹林新醫療社團法人林新醫院

¹Lin Shin Medical Corporation Lin Shin Hospital

Background and Purpose：Congenital Muscular Torticollis (CMT) is a common form of torticollis in infant. CMT is as a result of shortening or excessive contraction of the sternocleidomastoid muscle (SCM) with limited range of motion in rotation on the affected side and in lateral flexion on the non-affected side. The stretching exercises were usually used in clinical practice to release SCM, but might cause weakening neck muscles. This study aimed to use evidence-based practice to integrate current best evidence to reply the answerable clinical question: Dose the strengthening exercises could enhance the neck muscle functions of infants with CMT?

Methods: A systematic review was completed in Pubmed, Scopus, PEDro, and Airiti Library. Additionally, the following MeSH terms were synonymous with Congenital Muscular Torticollis and infant. The articles written in English and Chinese were limited by clinical trial and the publication dates were since 2010/01 until 2016/03. The inclusion criteria were as follows: (1) infants aged from 0 to 12 month-old, and (2) therapeutic methods were focus on strengthening and stretching exercises. The exclusion criteria were as follows: (1) therapeutic methods were kinesiology taping, microcurrent therapy, and surgical approach, and (2) the screening or diagnosis researches.

Results: Through the systematic review, there were 5 studies (OCEBM evidence level II) included. Totally 223 infants (130 boys) aged from 0-9 month-old were assessed. The strengthening exercises such as active and antigravity movements held at least 5-15 seconds were recommended. These exercises would enhance neck muscle function of infants with CMT and present better compliance for older infant with CMT than stretching exercises.

Conclusion: The strengthening exercises could enhance neck muscle function of infants with CMT, and recommended for 5-12 month-old infants with CMT. However, for 0-5 month-old infants with CMT, the stretching exercises were recommended instead. Treatment duration for both exercises was recommended 15-30 minutes/day, 2-3 days/week.

Keywords: Evidence-Based Practice, Congenital Muscular Torticollis, Infant, strengthening exercises