Physiotherapeutic management of Klippel-Feil syndrome: a systematic review with descriptive bibliometric analysis

Background/Aims Klippel-Feil syndrome is a rare congenital disorder characterised by fused cervical vertebrae and restricted neck mobility. This study systematically reviewed the available literature on the physiotherapeutic management of Klippel-Feil syndrome and conducted a descriptive bibliometric analysis to map publication trends, research characteristics and institutional contributions. Methods A systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Scopus and Google Scholar were systematically searched for studies published between January 1998 and December 2025. Eight case reports met the eligibility criteria for qualitative synthesis, with methodological quality evaluated using the Joanna Briggs Institute Critical Appraisal Checklist. Concurrently, a bibliometric analysis was performed on a manually screened dataset of 21 Scopus publications using VOSviewer (v1.6.20) to analyse annual publication trends, keyword co-occurrence, journal productivity and geographic distribution. Results Included studies indicated that tailored rehabilitation strategies, such as cervical strengthening, postural adjustments, range-of-motion exercises, scapular stabilisation, and functional training, correlated with reduced pain and improved cervical mobility, functional performance and quality of life. However, available evidence remains strictly limited to individual case reports, constraining data reliability and precluding definitive conclusions regarding optimal treatment efficacy. The bibliometric analysis demonstrated a modest but steady rise in publication activity over time, with key research clusters centred around Klippel-Feil syndrome, physiotherapy, cervical vertebrae, neck pain, range of motion, and scoliosis. Conclusions Physiotherapy represents a promising non-invasive component of comprehensive care for Klippel-Feil syndrome. However, prospective studies using standardised rehabilitation protocols and validated outcome measures are essential to establish treatment efficacy and guide clinical decision-making. Implications for practice Allied health professionals should consider individualised physiotherapy and rehabilitation as part of multidisciplinary management for Klippel-Feil syndrome, with interventions tailored to the patient's clinical presentation and associated abnormalities.