Manipulation techniques for infant torticollis

Tidsskr Nor Laegeforen. 2018 Dec 19; 138 (1). doi: 10.4045 / tidsskr.17.1031. Print 2019 Jan 15.
[Article in English, Norwegian]
Brurberg KG , Dahm KT , Kirkehei In .

BACKGROUND:
Practitioners in including chiropractic, physiotherapy, manual therapy and osteopathy recommend manipulation techniques to treat neck asymmetry in infants. This article summarizes research that evaluates such treatment.

MATERIAL AND METHOD:
The article is based on searches in MEDLINE, EMBASE, CINAHL, Cochrane CENTRAL, AMED, PEDro and Index to Chiropractic Literature in August 2017. Controlled studies were included to assess efficacy, and observation studies to elucidate the risk of injury.

RESULTS:
We went through 3,418 unique search hits. We included three randomized controlled trials on the efficacy of manual therapy or osteopathy and three observational studies on possible adverse effects. Two studies of manual therapy suggest that manipulation techniques have no greater effect on symmetry and motor outcomes than parental guidance, physiotherapy and home exercises. One study suggests that osteopathy may contribute to increased symmetry compared to placebo, but the clinical relevance of this change is uncertain. Neither the three randomized studies nor a large patient series involving 695 infants could demonstrate that manipulation techniques were associated with the risk of serious injury, but three patient histories document that manipulation techniques may damage if the observed asymmetry has serious underlying causes.

INTERPRETATION:
Manipulation techniques are not documented to be effective in the treatment of neural asymmetry in infants, but the available documentation is uncertain.

PMID: 30644674 DOI: 10.4045 / tidsskr.17.1031

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