International Journal of Science and Healthcare Research Vol.5; Issue: 3; July-Sept. 2020 Website: ijshr.com Case Report ISSN: 2455-7587 International Journal of Science and Healthcare Research (www.ijshr.com) 476 Vol.5; Issue: 3; July-September 2020 Effect of Institutional Based Physiotherapy Protocol on Cervical Active Ranges, Shoulder-To-Neck Posture and Oro-motor Functions in Congenital Muscular Torticollis with Unilateral Upper Limb Arthrogryposis: A Rare Interesting Case Report Abhijeet Arun Deshmukh Associate Professor, Department of Neuro-Physiotherapy, VSPM’s College Of Physiotherapy, Digdoh Hills, Hingna, Nagpur Maharashtra, India -440019 ABSTRACT Introduction: Congenital muscular torticollis (CMT) is a deformity result of unilateral shortening of the sternocleidomastoid muscle. Arthrogryposis Myogenic Congenita (AMC) i.e. amyoplasia is rare combination along with CMT in present case. To date no set protocol for the number of sessions, duration, frequency or dosage of the intervention mentioned and no study report about oro-motor dysfunction in children with CMT. Material and Methods: A 2year 8month old male child with congenital CMT and right upper limb arthrogryposis was evaluated in high sitting position for cervical active, shoulder neck angle was measured and external auditory meatus to acromion distance was measured. The oromotor dysfunction was evaluated subjectively by structured questionnaire and severity of affection was graded. Follow up evaluation was performed after 2weeks, 4weeks and 8weeks of treatment protocol and data was obtained for comparison. Data analysis and Results: SPSS version 10.0 was used for analysis. The data were compared first day of evaluation with 2weeks, 4weeks and 8weeks post intervention protocol for cervical active range of motion, ear-to-shoulder distance, and shoulder-neck angle along with grades of severity of oro-motor affection. There was improvement in active cervical ranges as well as shoulder neck angle and ear to shoulder distance reached to symmetry at the end of 8weeks treatment protocol. The oro-motor functions also reached to normal at 8weeks of treatment. Conclusion: The 8weeks institutional based Physiotherapy treatment protocol was effective in improving active ranges of cervical spine, symmetry in shoulder-to-neck posture as well as improve oro-motor functions to normal. Key words: Congenital Muscular Torticollis, Arthrogryposis, Goniometry, Physiotherapy, Intervention Protocol, Oro-Motor Function. INTRODUCTION Congenital muscular torticollis (CMT) is a deformity which is congenital or acquired in origin, characterized by lateral inclination of the head to shoulder, with torsion of the neck and deviation of the face. 1 CMT is a common postural and muscular disorder occurring at or shortly after birth 3 it is also known as wry neck or twisted neck. 2,3 CMT is a form of infantile torticollis that is clearly distinguished in the literature from non-muscular congenital causes of torticollis. 4 CMT result of unilateral shortening of the sternocleidomastoid (SCM) muscle which is caused by fibromatous contracture of SCM muscle and its shortening causes head tilt toward the ipsilateral side and chin rotation to the opposite side. 2-6 The congenital muscular torticollis (CMT) is the third most common congenital musculoskeletal anomaly after dislocation of the hip and clubfoot. 2,7 CMT affects 0.3% to 2% of newborns and infants with the