Objective: To evaluate the effectiveness of custom tailored osteopathic treatment compared to physiotherapy including handling instruction after Bobath´s concept in infants with idiopathic postural asymmetry.

Study design: Randomized controlled trial.

Methods: Three trained osteopaths conducted the study in their private practices in Dresden and Zittau, Germany. 59 infants, average age 8.4 ± 4 weeks, with a history of idiopathic postural asymmetry (asymmetry-score ≥ 2 according to Philippi et al., 2004) were included in the study. By means of external randomization 30 infants were allocated to the osteopathy group and 29 to the physiotherapy group. In the osteopathy group case histories and osteopathic examination were followed by 4 osteopathic treatments at weekly intervals. The custom tailored treatment was based on osteopathic principles. In the physiotherapy group examination and treatment were orientated on physiotherapy education principles in Germany. Primary outcome parameter was level of asymmetry including spontaneous and reactive movement in prone and supine position. Study-external blinded evaluators assessed video recordings (asymmetry-score validated by Philippi et al., 2004). In addition supporting function in prone position was evaluated. As secondary outcome parameters “handling at home and daily activities” (parents´ questionnaire), and “frequency of osteopathic dysfunctions” (osteopathic examination form) were recorded.

Results: The inter-group comparison of changes revealed statistically significant improvements in support of the osteopathic treatment for the main outcome parameter “level of infantile asymmetry” (asymmetry score: between group difference of means: -2.1; 95% CI: -2.4 to -1.7; p<0.005). In the osteopathy group level of asymmetry improved by 30%, and in the physiotherapy group by 15%. Supporting function in prone position enhanced statistically significant in favor of the osteopathy group (supporting score: between group difference of means -0.9; 95% CI: -1.1 to -0.8; p<0.005). The main osteopathic dysfunctions were identified in the sacral area and SI-joint followed by the diaphragm. Conclusion: Four osteopathic treatments over a period of four weeks led to statistically significant and clinically relevant positive changes of asymmetry level in infants with idiopathic postural asymmetry. These results support the findings of a former investigation (Philippi et al., 2006) indicating reproducibility.