Efficacy of Manual Physiotherapy Techniques for Improving Cervical Range of Motion in Infants With Congenital Muscular Torticollis: A Systematic Review and Meta‐Analysis

Background Congenital muscular torticollis (CMT) is characterized by unilateral shortening of the sternocleidomastoid muscle in early infancy and results in cervical range of motion (ROM) limitations. This study evaluated the efficacy of manual physiotherapy techniques for improving cervical ROM in infants with CMT. Methods A systematic review and meta‐analysis were conducted in accordance with the PRISMA guidelines. Four independent reviewers searched electronic databases from 2010 to 2025 to identify contemporary randomized controlled trials that aligned with current pediatric physiotherapy practice. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale, and effect sizes were calculated using standardized mean differences (Cohen's d). Results Five randomized controlled trials ( n = 143 infants) out of 183 identified records met the inclusion criteria and were included in the systematic review and meta‐analysis. PEDro scores ranged from 4 to 7 out of 10, with a mean score of 6.2 and a median score of 7, indicating moderate‐to‐good methodological quality. The forest plot demonstrated a statistically significant pooled effect in favor of manual therapy techniques for improving cervical ROM (Cohen's d = 0.90, 95% CI: 0.54 to 1.27, p < 0.001), indicating a large overall effect. Between‐study heterogeneity was low (I 2 = 9%; τ 2 = 0.02; H 2 = 1.10), suggesting limited variability in effect among the included studies. Conclusion Therapist‐directed manual physiotherapy techniques may provide clinically meaningful short‐term improvements in cervical ROM in infants with CMT. However, the small number of studies, variability in intervention protocols, and limited long‐term data warrant cautious interpretation. Future research may prioritize rigorous randomized controlled trials with standardized treatment protocols and long‐term follow‐up. Study registration The register number in the International Prospective Register of Systematic Reviews (PROSPERO) is CRD420261309454