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Research Article: Comparative outcomes of tuina therapy combined with functional exercise versus conventional physical therapy in infants with congenital muscular torticollis: a retrospective exploratory study

Date Published: 2026-06-29

Abstract:
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. 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. 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. 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. 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.

Introduction:
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.

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