Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trial.

The aim of this study was to assess the therapeutic efficacy of osteopathic treatment in infants with postural asymmetry. A randomized clinical trial of efficacy with blinded videoscoring was performed. Sixty-one infants with postural asymmetry aged 6 to 12 weeks (mean 9wks) were recruited. Thirty-two infants (18 males, 14 females) with a gestational age of at least 36 weeks were found to be eligible and randomly assigned to the intervention groups, 16 receiving osteopathic treatment and 16 sham therapy. After a treatment period of 4 weeks the outcome was measured using a standardized scale (4-24 points). With sham therapy, five infants improved (at least 3 points), eight infants were unchanged (within 3 points), and three infants deteriorated (not more than -3 points); the mean improvement was 1.2 points (SD 3.5). In the osteopathic group, 13 infants improved and three remained unchanged; the mean improvement was 5.9 points (SD 3.8). The difference was significant (p=0.001). We conclude that osteopathic treatment in the first months of life improves the degree of asymmetry in infants with postural asymmetry.

Idiopathic infantile asymmetry, proposal of a measurement scale.

UNLABELLED: To evaluate the development of idiopathic infantile asymmetry and the efficacy of therapeutic interventions, spinal scoliosis can be quantified on the basis of radiographs. For obvious reasons, use of this technique is limited. Here we present a clinical method to describe and quantify infantile asymmetry. For item selection, spontaneous movements (SMs), reactive movements (RMs) and length differences were video recorded in 30 infants (median age 10 weeks, range 6-16) with variable degrees of asymmetry. Within these three categories, reactive movements elicited by head turns to the right and left side in the prone and supine position emerged as reliable parameters reflecting trunk convexity and cervical rotation deficits. Six-point scales were developed for both measurements and added to form final scales. Consistency and interobserver reliability were evaluated in another 20 infants (median age 9 weeks, range 6-15) with variable degrees of asymmetry. Statistical analysis indicated good reliability and consistency of the testing method with an intraclass correlation coefficient of 91.5% (Cronbach alpha 0.84). CONCLUSION: During the first months of life, idiopathic infantile asymmetry can be clinically assessed using a highly consistent and reliable measurement scale describing degrees of trunk convexity and cervical rotations deficit.