Neural and visceral manipulation in infants with congenital muscular torticollis: a feasibility study.
Jean Anne Zollars, Patricia A Burtner, Gail Stockman and 3 others
PMID 32082020WHAT IT FOUND
Ten infants with congenital muscular torticollis tolerated a gentle neural and visceral manipulation approach without crying.
Their neck movement improved significantly after eight sessions and remained better four months later. This small study suggests the method is feasible but does not prove it works better than standard care.
Key findings
01All ten infants accepted the neural and visceral manipulation intervention, and results were achieved without crying or aversion to touch.
02The group showed statistically significant improvements in active and passive cervical rotation and passive lateral cervical flexion immediately after the eight sessions.
03Gains in cervical range of motion were retained four months after therapy was discontinued.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study had a very small sample size of only ten infants. There was no control group, so it is impossible to know if the improvements were due to the specific manipulation technique, the passage of time, or other factors like parental interaction. The number of therapy sessions was fixed at eight for all infants, which may not reflect optimal clinical practice where treatment duration is individualized. One infant had a later diagnosis of mild hemiparesis, which complicates the interpretation of individual outcomes. The authors state that findings are preliminary and require more rigorous study to determine actual efficacy.
Declared interests
The study was funded in part by a grant from the University of New Mexico Health Sciences Center Department of Pediatrics and statistical support from the National Institutes of Health. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the significant improvements in range of motion as proof that neural and visceral manipulation is more effective than traditional stretching. This was a single-group feasibility study with no control, so natural development or other unmeasured factors could explain the gains.