Frontiers in medicine · 2026
Comparative outcomes of tuina therapy combined with functional exercise versus conventional physical therapy in infants with congenital muscular torticollis: a retrospective exploratory study.
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Tian Xianzhu, Zhu Chaowen, Zhu Zhen, Nie Zixuan
Аннотация
BACKGROUND: Congenital muscular torticollis (CMT) is a common pediatric musculoskeletal condition managed with conservative physical therapy. Traditional Chinese Medicine Tuina therapy is used adjunctively in some settings, but high-quality comparative evidence is limited.
OBJECTIVE: To compare short-term clinical outcomes in infants with CMT who received combined Tuina therapy and functional exercise (integrated group) versus conventional physical therapy (control group) during routine care.
METHODS: Anonymized clinical records of 120 infants treated between January and June 2024 were retrospectively reviewed. Sixty infants received integrated Tuina-functional exercise and 60 received conventional physical therapy. Treatment allocation was non-randomized. Primary outcomes were cervical range-of-motion (ROM) deficit, sternocleidomastoid (SCM) muscle thickness ratio, and head tilt angle at 12 weeks. Between-group differences were analyzed using independent-samples t-tests, and 95% confidence intervals (CIs) and Cohen's d were reported. This study is reported in accordance with the STROBE statement.
RESULTS: Baseline characteristics were comparable between groups. At 12 weeks, the integrated group demonstrated greater mean change from baseline in ROM deficit (-25.9 ± 7.9° vs. -21.4 ± 9.3°; difference 4.4°, 95% CI 1.3-7.5, p = 0.006, d = 0.51), SCM thickness ratio (-1.35 ± 0.49 vs. -1.04 ± 0.55; difference 0.31, 95% CI 0.13-0.50, p = 0.001, d = 0.60), and head tilt angle (-19.8 ± 5.1° vs. -16.1 ± 5.2°; difference 3.7°, 95% CI 1.9-5.6, p < 0.001, d = 0.72). Home-program adherence was significantly higher in the integrated group (85.7 ± 11.2% vs. 78.0 ± 15.2%; p = 0.002). No serious adverse events were documented.
CONCLUSION: The combined Tuina-functional exercise program was associated with significantly greater improvements in all primary outcomes compared with conventional physical therapy. However, given the retrospective, non-randomized design and unequal therapist-contact time, findings should be considered exploratory. Prospective randomized controlled trials with blinded assessment and standardized treatment intensity are required.
OBJECTIVE: To compare short-term clinical outcomes in infants with CMT who received combined Tuina therapy and functional exercise (integrated group) versus conventional physical therapy (control group) during routine care.
METHODS: Anonymized clinical records of 120 infants treated between January and June 2024 were retrospectively reviewed. Sixty infants received integrated Tuina-functional exercise and 60 received conventional physical therapy. Treatment allocation was non-randomized. Primary outcomes were cervical range-of-motion (ROM) deficit, sternocleidomastoid (SCM) muscle thickness ratio, and head tilt angle at 12 weeks. Between-group differences were analyzed using independent-samples t-tests, and 95% confidence intervals (CIs) and Cohen's d were reported. This study is reported in accordance with the STROBE statement.
RESULTS: Baseline characteristics were comparable between groups. At 12 weeks, the integrated group demonstrated greater mean change from baseline in ROM deficit (-25.9 ± 7.9° vs. -21.4 ± 9.3°; difference 4.4°, 95% CI 1.3-7.5, p = 0.006, d = 0.51), SCM thickness ratio (-1.35 ± 0.49 vs. -1.04 ± 0.55; difference 0.31, 95% CI 0.13-0.50, p = 0.001, d = 0.60), and head tilt angle (-19.8 ± 5.1° vs. -16.1 ± 5.2°; difference 3.7°, 95% CI 1.9-5.6, p < 0.001, d = 0.72). Home-program adherence was significantly higher in the integrated group (85.7 ± 11.2% vs. 78.0 ± 15.2%; p = 0.002). No serious adverse events were documented.
CONCLUSION: The combined Tuina-functional exercise program was associated with significantly greater improvements in all primary outcomes compared with conventional physical therapy. However, given the retrospective, non-randomized design and unequal therapist-contact time, findings should be considered exploratory. Prospective randomized controlled trials with blinded assessment and standardized treatment intensity are required.