Measurement of Head Tilt in Infants with Congenital Muscular Torticollis

DOREEN BARTLETT, BSC, PT ANDSYLVIA COTTRILL-MOSTERMAN, BSc, OT, OTR*


Upon achieving full passive range of motion of the neck in infants with congenital muscular torticollis, the problem of a residual head tilt is often identified. A simple clinical device to measure this tilt was needed in order to record the change in head orientation in response to therapeutic intervention. An adapted goniometer was constructed. A carpenter's level bubble is fixed to one arm of a large, clear goniometer so that it is horizontal once the bubble is centered. The parent sits the child at the edge of a high mat, ensuring equal weight-bearing through each buttock. Crouching in front of the child with goniometer in hand, the therapist holds the arm with the bubble level while aligning the other arm with an imaginary line through the outer corners of the child's eyes. This angle is then read from the goniometer. The average of three measurements is considered to be the degree of head tilt. Most children demonstrate a slow resolution of the head tilt. This simple device provides objective measurement of improvement of head orientation.

*2871 Lyndene Road, North Vancouver, British Columbia V7R 1E2