Objective:
To evaluate whether osteopathic treatment combined with physiotherapy (according to Vojta) has an increased effectiveness on idiopathic infantile asymmetry than physiotherapy (according to Vojta) exclusively.

Study design:
Randomized controlled trial, evaluator blinded video analysis.

Setting:
Three osteopaths in their private practices in Solingen and Luedenscheidt conducted the study. Recruitment proceeded via several pediatricians and midwifes.
Patients:
Accepted for study participation were 55 infants aged between six and twelve weeks with infantile asymmetry (ZKS 1), pediatric examination and medial clearance certificate were precondition. By means of external randomization 28 infants were allocated to the Osteopathy/Vojta group and 27 to the Vojta group.

Intervention:
The infants of the Osteopathy/Vojta group received 7 treatments (5 osteopathic and 2 Vojta sessions). In the Vojta group 7 treatments took place as well (exclusively Vojta therapy). All parents were instructed to handle their infants according to the principles of Bobath (pediatric physiotherapy) and to position the baby. In each treatment session the home exercises were supervised.

Outcome parameter:
Primary outcome parameter was the level of connatal idiopathic asymmetry, recorded by the asymmetry-score according to Philippi et al. and with an assessment score for support function of the upper limbs (age of development/actual age). Four independent blinded evaluators reviewed the video material. Secondary outcome parameters were attendant symptoms and asymmetry-influencing variables.

Results:
The mean asymmetry-score of the infants being part of the Osteopathy/Vojta group improved about 4.15 points and respectively about 3.54 points in the Vojta group. A significant difference could not be determined. The analysis of the support function of the upper limbs provided a distinct younger age-estimation compared to the actual age (O/V = -3.06 weeks, V = -4.93 weeks). A complete asymmetry-release was not observed.

Conclusion:
A combination of osteopathic treatment and physiotherapy according to Vojta´s principles has a similar effect on idiopathic infantile asymmetry compared to Vojta therapy exclusive. It could be suspected that the improvement of infantile asymmetry in the Osteopathy/Vojta group base on the treatment of the osteopathic dysfunctions in not unimportant extent. Further long-term studies relating to this complex of problems are warranted.