Research title: Treatment of torticollis by Electrical stimulation of sternocleidomastoid muscle,

in patients who acquired torticollis secondary to the Traumatic Brain Injury

Introduction:
TBI is a vast medical condition ,the first and foremost thing to do with this patients is to begin
the physical therapy in this patients is very important, the therapist faces various kind of the
challenges like communication problems if the patients has lesions in brocas area and wernickes
area etcthe most disturbing problem faced by the therapist is the lack of the Neck control ,in
most of the cases due to the prolonged bed ridden condition or other conditions the patients
develop the torticollis ,the exact reason for development of the torticollis is un known here in this
article we are going to discuss about the two TBI cases,
The most commonly seen disability in tbi is drooling and dysphagia, aphasia and more
complications like uneven tone and lack of coordination,loss of proprioception this depend
totally upon the cerebellar lesions depending up on the severity of the lesion,in severe TBI like
diffuse axonal injury the patients lands up in coma for more than 3 days and for the restoration
of the normal functions of the patient is dependent upon the lesions,in this article we are going to
discuss about 2 patients who has the same neurological status post TBI,this two patients have
landedup in left side Torticollis,one patient has been treated with the electrical stimulation to
decrease the spasticity in the sternocleidomastoid muscle along with the standard
physiotherapeutic techniques and the second patient has been treated with only standard
physiotherapeutic techniques other then electrical modalities.
Torticollis is described as the wryneck ,the sternocleidomastoid muscle is involved, the same
side muscle is shortened and the opposite side muscle is lax .the nerve supply of this muscle is
spinal accessory nerve, my responsibility is not only to improve the tone of the two SCMs but
also to improve the motor function of the neck.

Objectives:
Primary objective:
To improve the normal range of motion[ROM] of the neck to treat the disability[torticollis], with
the therapeutic neuromuscular electrical stimulation.
Secondary objective:
Our secondary aim is to improve the Activities of the Daily living[ADLS] of the patient which is
directly dependent on the neck control of the patient, because without the neck control the
Therapist cannot initiate any kind of trunk control exercise ,except bed sided exercises.
Methodology:
In our treatment protocol by taking the opinion of the neurologist and prescription electrical
stimulation and anti spastic drug medications has been initiated Respectively along with the
physiotherapy in the both the cases.
The case follow up is taken place in Siddhartha Research Institute of the Medical sciences,with
the approals of the medical ethical committee of the institute.