Manual therapy of infants with postural and movement asymmetries and positional preference

Abstract

Background There are different therapeutic approaches to persistent positional preference (kinematic imbalance due to suboccipital strain, KISS) in infants. There are no evidence-based or controlled studies investigating the effect of manual medicine treatment in children aged 3–6 months, particularly in combination with a home exercise programme. The presented monocentric study on one-time manual medicine treatment of infants aged 14–24 exhibiting these symptoms aims to close this gap. Methods This study comprises a controlled double-blind trial and per-protocol-analysis. Primary outcome was the 4-item symmetry score (4–17 points). The second measurement was performed after 4–6 weeks. Results A total of 62 infants were treated and evaluated (mean age 17 weeks). The intervention and control groups started with a symmetry score of 12.9 ± 2.1 and 12.5 ± 1.7 points, respectively. In the intervention group the score improved by 4.9 ± 2.4 to 8.0 ± 2.7 points, in the control group it improved by 2.9 ± 2.9 to 9.6 ± 3.0 points. The difference between the groups was statistically significant (p = 0.03). Both groups had significantly better values over time (p < 0.001). No adverse events or side effects were observed. Conclusion Manual medicine treatment of infants with postural and movement asymmetries as well as positional preference in combination with a home exercise programme is superior to a home exercise programme alone. Both treatment concepts achieved significant improvements. However, the manual medicine treatment played an important role in reducing the symmetry score value for the affected children, such they were no longer in need of treatment.

Effects of Single Manual Medicine Treatment for Infants with Postural and Movement Asymmetries and Positional Preference: A Multicentre Randomised Controlled Trial – SMMT for IPMA

“…The findings (n=62) of another study group also demonstrated the significant superiority of a combination of one-time manual medicine treatment and HEP over the sole facilitation of physical activity in this age group (14–24 weeks) 35 .…”

“…By this point, the neurophysiological basis of this proprioceptive musculoskeletal coordination disorder has been analyzed and first evidence-based study results of a monocentre study have been published [34,35]. In a second step, a larger multicentre study population has now been used to investigate the effectiveness of a single manual medicine treatment (SMMT).…”

Haltungs- und Bewegungsasymmetrien im Säuglingsalter

“…Evidenz: Das Hausübungsprogramm für Säuglinge (>3 Monate) wurde als Basisbehandlung im Rahmen zweier vergleichbarer doppelblinder RCT (Randomized Controlled Trial, randomisierte kontrollierte Studie) (monozentrisch n=62; multizentrisch n=171) zur Therapie von mittelschweren und schweren Haltungs- und Bewegungsstörungen bei Säuglingen ohne systemische Grunderkrankung im Alter von 14–24 Wochen 3×täglich eingesetzt 20 21 . Die Beobachtungsdauer betrug 4–6 Wochen.…”

“…Für chirotherapeutische Interventionen liegen 2 doppelblinde RCT vor 20 21 , die in identischem Studiendesign angelegt sind. Dabei wurden Säuglinge mit mittelschweren und schweren Haltungs- und Bewegungsasymmetrien im Alter von 14–24 Wochen entweder einmalig manuell behandelt (Interventionsgruppe, IG) oder blieben manuell unbehandelt (Kontrollgruppe, KG).…”

“…Monozentrische RCT 20 : Es konnten 30 Kinder in der IG sowie 32 Säuglinge in der KG die gesamte Studie durchlaufen (Per-Protokoll-Analyse). Es zeigten sich signifikante Verbesserungen der Scoreitems in beiden Gruppen.…”