{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:45:55Z","timestamp":1782708355669,"version":"3.54.5"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Anonymized clinical records of 120 infants treated between January and June 2024 were retrospectively reviewed. Sixty infants received integrated Tuina\u2013functional 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\n                      <jats:italic>t<\/jats:italic>\n                      -tests, and 95% confidence intervals (CIs) and Cohen\u2019s d were reported. This study is reported in accordance with the STROBE statement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between groups. At 12 weeks, the integrated group demonstrated greater mean change from baseline in ROM deficit (\u221225.9 \u00b1 7.9\u00b0 vs. \u221221.4 \u00b1 9.3\u00b0; difference 4.4\u00b0, 95% CI 1.3\u20137.5,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006,\n                      <jats:italic>d<\/jats:italic>\n                      = 0.51), SCM thickness ratio (\u22121.35 \u00b1 0.49 vs. \u22121.04 \u00b1 0.55; difference 0.31, 95% CI 0.13\u20130.50,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001,\n                      <jats:italic>d<\/jats:italic>\n                      = 0.60), and head tilt angle (\u221219.8 \u00b1 5.1\u00b0 vs. \u221216.1 \u00b1 5.2\u00b0; difference 3.7\u00b0, 95% CI 1.9\u20135.6,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001,\n                      <jats:italic>d<\/jats:italic>\n                      = 0.72). Home-program adherence was significantly higher in the integrated group (85.7 \u00b1 11.2% vs. 78.0 \u00b1 15.2%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002). No serious adverse events were documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combined Tuina\u2013functional 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1869096","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:25:34Z","timestamp":1782707134000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative outcomes of tuina therapy combined with functional exercise versus conventional physical therapy in infants with congenital muscular torticollis: a retrospective exploratory study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xianzhu","family":"Tian","sequence":"first","affiliation":[{"name":"Jiujiang Traditional Chinese Medicine Hospital","place":["Jiujiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaowen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Jiujiang Maternity and Child Health Care Hospital","place":["Jiujiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Jiujiang Traditional Chinese Medicine Hospital","place":["Jiujiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixuan","family":"Nie","sequence":"additional","affiliation":[{"name":"Jiujiang Traditional Chinese Medicine Hospital","place":["Jiujiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1097\/PEP.0000000000001114","article-title":"Physical therapy management of congenital muscular torticollis: a 2024 evidence-based clinical practice guideline from the American Physical Therapy Association Academy of Pediatric Physical Therapy.","volume":"36","author":"Sargent","year":"2024","journal-title":"Pediatr Phys Therapy."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e20190582","DOI":"10.1542\/peds.2019-0582","article-title":"Congenital muscular torticollis: bridging the gap between research and clinical practice.","volume":"144","author":"Sargent","year":"2019","journal-title":"Pediatrics."},{"key":"B3","doi-asserted-by":"publisher","first-page":"9133","DOI":"10.3390\/ijerph19159133","article-title":"Incidence of congenital muscular torticollis in babies from southern Portugal: types, age of diagnosis and risk factors.","volume":"19","author":"Minghelli","year":"2022","journal-title":"Int J Environ Res Public Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1007\/s00264-021-05279-9","article-title":"Clinical features and management of developmental dysplasia of the hip in congenital muscular torticollis.","volume":"46","author":"Gou","year":"2022","journal-title":"Int Orthopaed."},{"key":"B5","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1097\/PEP.0000000000000544","article-title":"Physical therapy management of congenital muscular torticollis: a 2018 evidence-based clinical practice guideline from the APTA Academy of Pediatric Physical Therapy.","volume":"30","author":"Kaplan","year":"2018","journal-title":"Pediatr Phys Therapy."},{"key":"B6","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3390\/children11010008","article-title":"Effectiveness of the treatment of physiotherapy in congenital muscular torticollis: a systematic review.","volume":"11","author":"Rodr\u00edguez-Huguet","year":"2024","journal-title":"Children."},{"key":"B7","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1097\/PEP.0000000000000993","article-title":"Informing the physical therapy management of congenital muscular torticollis clinical practice guideline: a systematic review.","volume":"35","author":"Castilla","year":"2023","journal-title":"Pediatr Phys Therapy."},{"key":"B8","doi-asserted-by":"publisher","first-page":"101112","DOI":"10.1016\/j.ctcp.2020.101112","article-title":"Traditional Chinese medicine (TCM) massage for the treatment of congenital muscular torticollis (CMT) in infants and children: a systematic review and meta-analysis.","volume":"39","author":"Chen","year":"2020","journal-title":"Complement Ther Clin Pract."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e32086","DOI":"10.1097\/MD.0000000000032086","article-title":"Combined effect of external treatment of herbal medicine and tuina in congenital muscular torticollis: systematic review and meta-analysis.","volume":"101","author":"Kim","year":"2022","journal-title":"Medicine."},{"key":"B10","doi-asserted-by":"publisher","first-page":"984675","DOI":"10.3389\/fped.2022.984675","article-title":"Effect of massage therapy on infants with congenital muscular torticollis: a retrospective comparative study.","volume":"10","author":"Tang","year":"2023","journal-title":"Front Pediatr."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1594911","DOI":"10.3389\/fped.2025.1594911","article-title":"Efficacy and safety analysis of massage and medium-frequency electrotherapy in the treatment of congenital muscular torticollis in infants.","volume":"13","author":"Lin","year":"2025","journal-title":"Front Pediatr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1097\/PEP.0b013e31815ebb27","article-title":"Reference values for range of motion and muscle function of the neck in infants.","volume":"20","author":"\u00d6hman","year":"2008","journal-title":"Pediatr Phys Therapy."},{"key":"B13","doi-asserted-by":"publisher","first-page":"7177","DOI":"10.3390\/ijerph20247177","article-title":"Congenital muscular torticollis\u2014Current understanding and perinatal risk factors.","volume":"20","author":"P\u0142omi\u0144ski","year":"2023","journal-title":"Int J Environ Res Public Health."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e26998","DOI":"10.1097\/MD.0000000000026998","article-title":"Effect of physical therapy intervention on thickness and ratio of the sternocleidomastoid muscle and head rotation angle in infants with congenital muscular torticollis: a randomized clinical trial (CONSORT).","volume":"100","author":"Song","year":"2021","journal-title":"Medicine."},{"key":"B15","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1080\/09593980802686904","article-title":"Validity and reliability of the Muscle Function Scale, aimed to assess the lateral flexors of the neck in infants.","volume":"25","author":"\u00d6hman","year":"2009","journal-title":"Physiother Theory Pract."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1869096\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:25:36Z","timestamp":1782707136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1869096\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":15,"alternative-id":["10.3389\/fmed.2026.1869096"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1869096","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"article-number":"1869096"}}