Neural and visceral manipulation in infants with congenital muscular torticollis: a feasibility study

Abstract

As an alternative to manual stretching, the aim of this study was to investigate the feasibility of using neural/visceral manipulation as a safe and effective intervention to increase neck range of motion of infants with congenital muscular torticollis. [Participants and Methods] Ten 4-month old infants with congenital muscular torticollis received eight sessions of neural/visceral manipulation administered for 30-50 minutes without observed pain. Specific palpation techniques addressed restricted tissue areas of neck, head, trunk and extremities. Neck rotation and lateral flexion were assessed by still photography and a computer program calculating ROM angles before, immediately following, and 4 months post intervention. Motor development and social competence were monitored over time using the Alberta Infant Motor Scale and Bayley-III Social Emotional Scale. [Results] Results of analysis of variances revealed significant improvements in passive and active neck rotation and lateral flexion. Significant increases were also found on the Alberta Infant Motor Scale and Bayley-III Social-Emotional scale. [Conclusion] Neural/visceral manipulation can be used safely in infants with congenital muscular torticollis to improve neck range of motion.

Informing the Physical Therapy Management of Congenital Muscular Torticollis Clinical Practice Guideline: A Systematic Review

“…Newer evidence supports that manual techniques, such as TCM massage27,28 and neural and visceral manipulation,32 may be feasible, but further high-quality research is needed to establish efficacy. This is consistent with previous research that demonstrated the feasibility of myokinetic stretching,44 and evidence that a home program and soft tissue mobilization, compared with a home program alone, resulted in improved outcomes after 6 weeks of intervention, but no difference after 12 weeks of intervention or at follow-up 45.…”

“…Six studies informed PT intervention for infants with CMT: 1 SR, 27 2 RCTs, 28,31 1 cohort study, 32 1 retrospective study, 29 and 1 qualitative study on the experiences of parents of infants with CMT. 30…”

Factors influencing and long-term effects of manual myotomy phenomenon during physiotherapy for congenital muscular torticollis

“…Treatment approaches for CMT include observation only, physical therapy, neural and visceral manipulation, medicine injection, and surgery [ 17 , 23 , 24 ]. Early intervention for infants with CMT aims to prevent craniofacial deformity, limitations in neck motion, imbalance in muscle strength, and spinal deformity [ 1 , 2 ].…”

Factors Influencing and Long-Term Effects of Manual Myotomy Phenomenon During Physiotherapy for Congenital Muscular Torticollis

“…The non-conditional logistic regression analysis showed that age at initial physiotherapy session was the only risk factor for the occurrence of MM during physiotherapy in infants with CMT (P < 0.05; Table 5). [17,23,24]. Early intervention for infants with CMT aims to prevent craniofacial deformity, limitations in neck motion, imbalance in muscle strength, and spinal deformity [1,2].…”