Diagnostics and treatment of infants suspected with kinematic imbalance due to suboccipital strain (KISS)
KISS is an acronym for Kinematic Imbalance due to Suboccipital Strain, and a term being used to describe a possible causal relation between imbalance in the upper neck joints in infants and symptoms like postural asymmetry, development of asymmetric motion patterns, hip problems, sleeping and eating disorders. Several academic disciplines (e.g. manual therapist, chiropractors and osteopaths) are currently offering treatment to infants suspected to have KISS, a treatment typically consisting of spinal manipulation of the upper neck joints, relaxing- and mobilisation exercises. Treatment is often followed up by paediatric physiotherapists who stimulate development of a symmetric motion patterns and build muscular strength.
To make this report, several databases have been systematically searched to reveal research literature evaluating the effectiveness of different techniques used to treat infants with KISS. Databases were also searched for evidence of adverse effects and studies examining the accuracy (validity) of various diagnostic tests.
At the present there is no gold standard or standardized ways to diagnose infants suspected for KISS, but some commenced projects may provide valuable results in the future.
We identified one randomized controlled trial showing that osteopathy can potentially reduce the degree of postural asymmetry among infants, but the study did not reveal any changes in vegetative parameters following treatment. It has to be emphasized that these conclusions are based solely on one small study, suggesting that the strength of the evidence is too low to make reliable conclusions about treatment effects.
We did not find evidence suggesting that the use of manual therapeutic, osteopathic or chiropractic treatment strategies in infants is associated with risk of injuries or harmful side effects, but the level of evidence is very low.