Development of a questionnaire to identify ocular torticollis
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ORIGINAL ARTICLE
Development of a questionnaire to identify ocular torticollis Jin A. Yoon 1,2 & Heeyoung Choi 2,3 & Yong Beom Shin 1,2 & Hyeshin Jeon 2,3 Received: 4 August 2020 / Revised: 11 September 2020 / Accepted: 15 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Ocular disease is one of the causes of abnormal head positioning. Conventionally, the behavioral characteristics of ocular torticollis patients are different from those of non-ocular torticollis patients, though research addressing the significance of this difference is yet limited. This prospective, cross-sectional study aims to develop a questionnaire based on the clinical features in children with abnormal head posture being ocularly assessed. Children aged ≥ 6 months who visited our rehabilitation medicine clinic with a chief complaint of abnormal head posture were included. Patients with apparent orthopedic and neurological diseases were excluded. A 10-item questionnaire was developed to analyze the behavioral characteristics of patients. The patients were divided into ocular and non-ocular torticollis groups according to ophthalmologic examination results. Thirty-four and 13 patients were assigned to the nonocular torticollis and ocular torticollis groups, respectively. Five questions were finally selected and the questionnaire was scored as the sum of the scores for the each questions (yes = 1 point, no = 0 point). The median (interquartile range) score of the ocular torticollis group (3.0 (3.0–4.0)) was significantly higher than that of the non-ocular torticollis group (2.0 (1.0–3.0); p = 0.000). Conclusion: Our parent-reported torticollis assessment questionnaire may be useful for screening ocular torticollis. What is known: • Ocular disease is one of the various causes of abnormal head positioning. • The behavioral characteristics of ocular torticollis patients are different from those of non-ocular torticollis patients; research on this matter is limited. What is new: • We developed a questionnaire to differentiate ocular and postural torticollis. • The score of the questionnaire was different between patients with or without ocular disease. • The questionnaire based on behavioral characteristics may help screening and determining the need of ophthalmic evaluation in patients with torticollis.
Keywords Torticollis . Abnormal head posture . Strabismus . Rehabilitation
Abbreviations ROC Receiver operation characteristic AUC Area under curve
SE CI
Standard error Confidence interval
Communicated by Gregorio Paolo Milani * Hyeshin Jeon [email protected] Jin A. Yoon [email protected] Heeyoung Choi [email protected] Yong Beom Shin [email protected]
1
Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, South Korea
2
Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
3
Department of Ophthalmology, Pusan National University Hospital, Busan, South Korea
Eur J Pediatr
Introduction Torticollis or abnormal head posture is
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