A new explorative qualitative study published in BMC Pediatrics by Salome Keller of the Zurich University of Applied Science and colleagues at the Department of Chiropractic Medicine at University Hospital Balgrist and the University of Zurich has now documented, in parents’ own words, how attitudes toward chiropractic intervention evolve across the course of treatment for infants with suspected arthrogenic torticollis. The research team recruited families whose babies had been referred to chiropractic care with a suspected diagnosis of the condition and conducted semi-structured interviews at two points in time: a baseline round with twelve parents before or at the start of treatment, and a follow-up round with seven parents after they had experienced the therapy firsthand. The design allowed the investigators to compare expectations and fears before treatment with perceptions and judgments afterward, capturing a psychological trajectory that is rarely documented in this clinical population.

Methodologically, the study followed a deductive-inductive qualitative analysis based on Kuckartz’s approach, a structured framework for qualitative content analysis that combines theory-driven categories with themes emerging from the data themselves. All interviews were coded using MAXQDA 24, a widely used software platform for qualitative research, and the reporting was guided by the COREQ checklist, an international standard designed to improve the transparency and completeness of qualitative study reporting. From this analysis, four main themes crystallized: everyday life, perception of the infant’s health status, prior knowledge, and attitude toward chiropractic treatment. These themes formed an interpretive map of the parental experience, showing how the practical demands of caring for an affected infant, the parents’ reading of their child’s condition, whatever they knew beforehand about manual therapy, and their evolving stance toward the treatment all interacted to shape the overall journey.

The baseline interviews revealed a striking emotional landscape. Parents initially experienced considerable uncertainty and emotional strain, driven by two distinct sources. The first was simple unfamiliarity: chiropractic care for infants is not part of most parents’ medical vocabulary, and many did not know what the treatment would entail, how safe it was, or what evidence supported it. The second source was more visceral: watching a practitioner apply manual techniques to a tiny, fragile baby provoked anxiety that no amount of rational reassurance could entirely dispel. The researchers found that this ambivalence, a mixture of hope that the therapy would help and fear that it might somehow harm, was a defining feature of the pre-treatment mindset. Parents arrived at the clinic carrying questions they often felt hesitant to ask, and their first encounters with the treatment setting were colored by this underlying tension.

What happened next, according to the follow-up interviews, was a gradual transformation. As parents became familiar with the process, observing what the practitioner actually did, understanding the gentle nature of the techniques used on infants, and seeing how their baby responded during and after sessions, their emotional state shifted measurably. Confidence grew. Trust in the professionals deepened. Acceptance of the treatment, which had been tentative at best before the first session, solidified into genuine endorsement. Crucially, the researchers identified a powerful catalyst for this shift: observable improvement in the infant’s condition. When parents could see their child turning the head more freely, holding it more symmetrically, or feeding and sleeping more comfortably, their abstract anxieties about the therapy gave way to concrete, experience-based conviction that the intervention was working.

The study’s findings on the factors shaping parental attitudes carry practical weight for clinicians. Three elements stood out as decisive. Clear communication emerged as the foundation: parents who received thorough explanations of the diagnosis, the rationale for chiropractic treatment, and what each session would involve reported far less distress and far greater engagement than those left to guess. Observable health benefits formed the second pillar, providing the experiential evidence that no verbal reassurance could replace. Prior experience with therapeutic interventions for their infant constituted the third factor: families who had already navigated physiotherapy or other treatments for their child arrived with a framework for understanding a new therapy, which buffered the initial shock of the unfamiliar. Together, these factors suggest that the trajectory from skepticism to trust is not automatic but is actively constructed through information, demonstration, and results.

The clinical context makes these findings particularly significant. Arthrogenic torticollis, involving the upper cervical joints, is precisely the kind of diagnosis that prompts parents to seek specialized manual assessment, and chiropractic medicine in Switzerland, where the study was conducted, is an integrated, university-trained medical discipline rather than an alternative practice. At University Hospital Balgrist, chiropractic medicine operates within the hospital system, with practitioners trained to medical standards. Nevertheless, the researchers emphasize that the general public often does not distinguish between regulated, hospital-based chiropractic care and less formally grounded versions of the practice, which contributes to the initial wariness parents bring through the clinic door. The gap between the actual, regulated nature of the treatment and parental perceptions of it is exactly where communication interventions can do the most good.

The broader implications extend well beyond this single condition. The study offers a template for understanding how families engage with any unfamiliar treatment for infants, a situation that arises constantly in pediatrics, from osteopathy to novel physiotherapy protocols to emerging conservative orthopedic approaches. The central insight is that parental acceptance is dynamic, not fixed: it can be cultivated through structured communication and validated through visible outcomes. The authors highlight that supporting families through this psychological transition does more than improve satisfaction scores; it reduces stress during the infant’s care, and reduced parental stress is itself a meaningful clinical outcome, given how strongly caregiver anxiety can affect feeding, bonding, and the consistency with which families complete a treatment course.

The researchers are careful about the scope of their conclusions. As an explorative qualitative study with twelve baseline and seven follow-up participants, it cannot quantify how common each attitude pattern is, nor can it speak to the clinical efficacy of chiropractic treatment for arthrogenic torticollis itself, which was not the object of investigation. What it does establish, with methodological transparency, is the shape of the parental experience: an arc that begins in uncertainty and emotional strain, passes through familiarization and observation, and ends, for the families studied, in confidence and acceptance. The deductive-inductive coding framework and adherence to the COREQ checklist strengthen the trustworthiness of the thematic findings, and the two-timepoint design gives the study a longitudinal dimension that most qualitative work in this area lacks.

For parents facing a torticollis diagnosis, the study’s message is quietly reassuring: the fear and ambivalence they may feel before their infant’s first chiropractic session are common, documented, and, according to the families interviewed, likely to fade as understanding and visible progress replace the unknown. For clinicians, the message is more actionable. Every explanation offered before a session, every question answered patiently, and every improvement pointed out explicitly is not merely courtesy but an active ingredient in the therapy’s acceptance. In a field where the youngest patients cannot voice their own experience and their caregivers hold the decision-making power entirely, the psychology of the parent may be as important to a treatment’s success as the technique applied to the infant’s neck. This Swiss study makes that psychology visible, and in doing so, offers both families and practitioners a clearer map of the emotional terrain they must cross together.

Subject of Research: Parental attitudes toward chiropractic treatment of infants with arthrogenic torticollis

Article Title: Parental attitude towards chiropractic intervention before and after treatment in infants with an arthrogenic torticollis: an explorative qualitative study

Article References: Keller, S., Paravicini, I., Wirth, B., Schweinhardt, P., & Langenfeld, A. (2026). Parental attitude towards chiropractic intervention before and after treatment in infants with an arthrogenic torticollis: an explorative qualitative study. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07760-z

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07760-z

Keywords: arthrogenic torticollis, chiropractic care, parental attitude, infants, manual therapy, parental stress, healthcare communication, pediatrics, qualitative research, congenital muscular torticollis, cervical spine, physiotherapy