# Comparison of the Effectiveness of Vojta Therapy and the NDT Bobath Concept in the Treatment of Congenital Muscular Torticollis in Infants—A Retrospective Cohort Pilot Study

## TL;DR

This study compares two physiotherapy methods for treating infant neck muscle issues and finds one to be more effective, especially when started early.

## Contribution

A pilot comparison of Vojta and NDT Bobath therapies for CMT with biomechanical outcome measures.

## Key findings

- Vojta therapy showed significantly greater improvements in head tilt and neck rotation compared to NDT Bobath.
- Early intervention (1–2 months) was associated with a higher likelihood of achieving optimal movement thresholds.
- Effect sizes were large, suggesting clinically meaningful improvements, but functional outcomes were not assessed.

## Abstract

Background/Objectives: Congenital muscular torticollis (CMT) affects 0.3–3.9% of infants, requiring early physiotherapy to prevent deformities. Vojta and NDT Bobath therapies are widely used, yet comparative evidence remains limited. To compare Vojta versus NDT Bobath efficacy in improving head tilt and cervical rotation in infants with CMT. Methods: Retrospective cohort study (2016–2024) at Polish Mother’s Memorial Hospital included 53 infants under 5 months with ultrasound-confirmed CMT. Non-random allocation based on therapist availability introduced selection bias. Participants received Vojta (n = 29) or NDT Bobath (n = 24) two 30 min sessions weekly for 20 weeks plus home exercises. Blinded physicians measured outcomes. Results: Vojta showed greater angular improvements versus NDT Bobath: head tilt MD = −5.69° (p < 0.001, Hedges’ g = 1.29) and neck rotation MD = −5.89° (p < 0.001, Hedges’ g = 1.21). Early intervention (1–2 months) demonstrated 5-fold (RR = 5.46) and 8-fold (RR = 8.19) higher likelihood of achieving optimal thresholds (70°/90°) versus later intervention (3–4 months) both p < 0.001. No therapy × age interaction was found, indicating consistent between-group differences across age strata. Large effect sizes suggest clinically meaningful angular improvements. Conclusions: Vojta therapy was associated with superior angular outcomes versus NDT Bobath, with early initiation showing better results. However, the retrospective non-randomized design, small sample (n = 53), and absence of functional outcome assessment limit causal inference. Only biomechanical outcomes were measured; functional motor development, complications, and quality of life were not evaluated. Prospective randomized trials with functional assessments and larger samples are essential to confirm these associations and determine clinical significance.