Disease spectrum of torticollis in children and diagnostic flowchart: A retrospective, single-centre study.

AIM: To describe the disease spectrum of torticollis in Chinese children and to improve its diagnostic flowchart. METHODS: A retrospective analysis was conducted at the Rehabilitation Department of Beijing Children's Hospital from 2017 to 2021. Patients were diagnosed and referred based on a diagnostic flowchart of torticollis. Detailed patient data were collected from the outpatient electronic medical record system. RESULTS: A total of 2047 patients met the inclusion criteria. The top five conditions were congenital muscular torticollis (CMT) (76.6%), cerebral palsy (5.1%), ocular torticollis (4.7%), brachial plexus injury (1.9%) and atlantoaxial rotary subluxation (1.3%). CMT was most common in 0-2 year olds, cerebral palsy in 3-5 year olds, and atlantoaxial rotary subluxation in 7-12 year olds. The top five referral departments were orthopaedics, ophthalmology, otolaryngology, head and neck surgery, neurology and neurosurgery. CONCLUSIONS: The disease spectrum of torticollis in children and the diagnostic flowchart provide important references for diagnosing torticollis, which necessitates multidisciplinary collaboration.

Kinematic Characteristics of Gait for Children with Spastic Cerebral Palsy / 医用生物力学

Objective To analyze kinematic characteristics of children with spastic cerebral palsy during walking based on the method of gait analysis. Methods The gait of 14 children with spastic cerebral palsy and 16 healthy children, who were required to walk back and forth on level ground at normal speed, was tested using portable gait analyzer. The gait differences between diseased side and healthy side of lower limbs for children with spastic cerebral palsy, as well as the gait differences between children with spastic cerebral palsy children and healthy children were compared. Results For children with spastic cerebral palsy, single step time, swing time and toe-off time of diseased side were significantly longer than those of healthy side (P＜0.05), while step frequency, velocity and terminal stance were significantly shorter than those of healthy side (P＜0.05). Compared with healthy children, gait cycle time, single step time, stance time, swing time, percentage of stance phase, mid stance phase, pre-swing stage and toe-off time for diseased side of children with spastic cerebral palsy were significantly longer (P＜0.05). Stride, velocity, step frequency and terminal stance of the children with spastic cerebral palsy were significantly lower than those of healthy children (P＜0.05). Pulling acceleration for children with spastic cerebral palsy also decreased compared with healthy children (P=0.05). Conclusions The stability of children with spastic cerebral palsy decreased during walking, and their single step time, swing time, toe-off time and pulling acceleration might be considered as the sensitive indicators.