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

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 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, 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.