National Physical Therapy Examination (NPTE) Practice Exam

What is the best treatment for a four-month-old with congenital torticollis and a positional asymmetry of the orbits?

1. Sitting on the physical ball with gentle passive rocking

2. Deep neck flexor strengthening

3. Stretching of the left sternocleidomastoid

4. Stretching of the right sternocleidomastoid

The correct answer is: Stretching of the right sternocleidomastoid

In the case of a four-month-old with congenital torticollis, the primary treatment approach focuses on addressing the muscle imbalance and restoring symmetrical positioning. Torticollis often involves a shortening of one sternocleidomastoid muscle, which leads to a characteristic head tilt and associated asymmetries, such as positional asymmetry of the orbits. For this child, stretching the right sternocleidomastoid muscle would be the best course of action, assuming the left side is affected. The goal of this stretching is to elongate the muscle that is tight, which can help to correct the head tilt and improve the overall symmetry of the head and neck positioning. Stretching is an essential part of management because it not only helps in improving range of motion but also in preventing further complications associated with muscular imbalances. In this context, it’s important to note that while other options might contribute to an overall treatment plan, they are not as direct or effective in addressing the immediate issue of muscle tightness and positional asymmetry. Sitting on a physical ball focuses on stability and balance rather than direct muscle management; deep neck flexor strengthening would likely not be beneficial at such an early age with pronounced muscle tightness; and stretching the left sternoc