Combined Effects of Manual Therapy and Functional Electrical Stimulation on Torticollis among Adults

Main Article Content

Fatima Zahra
Aliza Shahbaz
Malik Muhammad Atif
Muhammad Dilshad
Mateh Ur Rehman
Ahsan Rasool


Background: Acquired muscular torticollis is a common musculoskeletal disorder that occurs after birth due to various etiologies. This condition is characterized by the abnormal tilt and twist of the neck muscles, causing significant discomfort and functional impairment.

Objective: This study aimed to investigate the combined effects of manual therapy and functional electrical stimulation (FES) on adults with acquired torticollis.

Methods: A 45-year-old male patient with acquired torticollis was evaluated using a detailed general movement assessment and an arthrodial goniometer to measure cervical ranges of motion. The patient exhibited tightness of the right sternocleidomastoid (SCM) muscle with limited ranges of motion. The treatment protocol included both manual therapy and electrotherapy for three months, with sessions conducted four days per week, each lasting 40 minutes. Manual therapy consisted of soft tissue mobilization, stretching of the right SCM, and isometric exercises for the left SCM. Electrotherapy included transcutaneous electrical nerve stimulation (TENS), DL2 stimulator, infrared radiation therapy (IRR), and ultrasonic therapy. The patient’s cervical ranges of motion were measured before and after the intervention to assess the effectiveness of the combined therapy.

Results: Significant improvements were observed in the patient’s cervical ranges of motion after the 12-week treatment protocol. The mean lateral flexion of the affected right SCM improved from 35 degrees to 20 degrees, and the mean rotation improved from 43 degrees to 28 degrees. These changes indicate a noticeable improvement in both the ranges of motion and posture of the patient.

Conclusion: The combined effects of manual therapy and functional electrical stimulation significantly improved the cervical ranges of motion and overall posture in an adult patient with acquired torticollis. These findings suggest that integrating multiple therapeutic modalities can enhance treatment outcomes for musculoskeletal deformities.

Article Details

How to Cite
Zahra, F., Aliza Shahbaz, Malik Muhammad Atif, Muhammad Dilshad, Mateh Ur Rehman, & Ahsan Rasool. (2024). Combined Effects of Manual Therapy and Functional Electrical Stimulation on Torticollis among Adults. Journal of Health and Rehabilitation Research, 4(2), 1145–1149.
Author Biographies

Fatima Zahra, Government College University Faisalabad Pakistan.

Student of Doctor of Physical Therapy, Government College University Faisalabad Pakistan.

Aliza Shahbaz, Government College University Faisalabad Pakistan.

Student of Doctor OF Physical Therapy, Government College University Faisalabad Pakistan.

Malik Muhammad Atif, University of Sargodha Pakistan.

Department of Allied Health Sciences, University of Sargodha, Pakistan.

Muhammad Dilshad, Riphah International University Lahore Pakistan.

Riphah International University, Lahore, Pakistan.

Mateh Ur Rehman, CMA Hospital Pakistan.

Clinical Physiotherapist, CMA Hospital, Pakistan. Riphah International University Lahore, Pakistan.

Ahsan Rasool, Siddique Hospital Sialkot Pakistan.

Clinical Physiotherapist, Siddique Hospital Sialkot, Pakistan. Riphah International university, Lahore, Pakistan.


Kaur S. Congenital Torticollis and Its Physiotherapy Management. Int J Health Sci Res. 2020;10:94-101.

Kim OH, Lee SW, Ha EK, Kim JH, Jo YH, Rhie S, et al. Neurodevelopmental Outcomes and Comorbidities of Children with Congenital Muscular Torticollis: Evaluation Using the National Health Screening Program for Infants and Children Database. Clin Exp Pediatr. 2022;65(6):312.

Minghelli B, Vitorino NGD. Incidence of Congenital Muscular Torticollis in Babies from Southern Portugal: Types, Age of Diagnosis and Risk Factors. Int J Environ Res Public Health. 2022;19(15):9133.

Arganbright JM, Brown JR. Torticollis. In: Pearls and Tricks in Pediatric Surgery. 2021:313-7.

Beasley SW. Torticollis. In: Pediatric Surgery: General Pediatric Surgery, Tumors, Trauma and Transplantation. 2021:31-43.

Antares JB, Jones MA, King JM, Chen TMK, Lee CMY, Macintyre S, Urquhart DM. Non-Surgical and Non-Pharmacological Interventions for Congenital Muscular Torticollis in the 0-5 Year Age Group. Cochrane Database Syst Rev. 2018;2018(3).

Kim E, Choi J, Min SY. External Treatment of Herbal Medicine with Tuina in Congenital Muscular Torticollis: A Protocol for Systematic Review and Meta-Analysis. Medicine. 2022;101(10).

Płomiński J, Olesińska J, Kamelska-Sadowska AM, Nowakowski JJ, Zaborowska-Sapeta K. Congenital Muscular Torticollis—Current Understanding and Perinatal Risk Factors: A Retrospective Analysis. Healthcare. 2023;11(4):512.

Kim SM, Cha B, Jeong KS, Ha NH, Park MC. Clinical Factors in Patients with Congenital Muscular Torticollis Treated with Surgical Resection. Arch Plast Surg. 2019;46(5):414-20.

Zahid T, Asif I. A Review of Efficacy of Various Cervical Orthoses in Congenital Muscular Torticollis. Asia Pac J Allied Health Sci. 2022;5(2):98-104.

Durguti Z, Murtezani A, Spahiu L, Durguti T, Gara E. Management of Infants with Congenital Muscular Torticollis. J Pediatr Neurol. 2019;17(4):138-42.

Rodríguez-Huguet M, Rodríguez-Almagro D, Rosety-Rodríguez MA, Vinolo-Gil MJ, Ayala-Martínez C, Góngora-Rodríguez J. Effectiveness of the Treatment of Physiotherapy in the Congenital Muscular Torticollis: A Systematic Review. Children. 2023;11(1):8.

Thompson R, Kaplan SL. Frequency-Specific Microcurrent for Treatment of Longstanding Congenital Muscular Torticollis. Pediatr Phys Ther. 2019;31(2).