Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Apr 9;25(1):282.
doi: 10.1186/s12887-025-05627-3.

Focus on physiotherapy and manual therapy for infants in Norway, a cross-sectional study on referral practice, and planned interventions

Hege Handeland  1 , Kari Anne Indredavik Evensen  2   3   4 , Hilde Stendal Robinson  5
Affiliations
Observational Study

Focus on physiotherapy and manual therapy for infants in Norway, a cross-sectional study on referral practice, and planned interventions

Hege Handeland et al. BMC Pediatr. .

Abstract

Background: The Norwegian health care system has a mandatory program for close and systematically follow-up on all children, starting in early infancy through the Child Health Care Centers in the municipalities. Additionally, some infants are referred to physiotherapists and manual therapists for several reasons. Little is known about who is referring them and the cause for the referral. In Norway, physiotherapists working with infants can be employed in the communities or work in outpatient clinics, both are within the primary health care system. The main purpose of the present study was to explore the referral practice of infants to physiotherapy and compare those treated by physiotherapists and manual therapists in primary health care in Norway. Furthermore, to describe the planned interventions.

Methods: Cross-sectional study including 444 infants (age under 12 months) referred to physiotherapists or manual therapists working in primary health care in Norway.

Results: Median age (range) of the infants was 14 (1, 52) weeks and 344 were born at due date. Most infants examined by a physiotherapist were referred from other health personnel and more of the referrals to manual therapists were from parents due to their concern. Age at examination was between week 1-12 for 42% of the participants. Infants referred for motor development problems were equally distributed between the physiotherapists and manual therapists. All premature infants were referred to the physiotherapists. Concerning the interventions, both physiotherapists and manual therapists planned to use advice, handling, and stimulation. More of the physiotherapists reported to focus on advice related to motor development and the use of prone play.

Conclusion: The infants in Norway are referred to physiotherapists and/or manual therapists for numerous reasons, and the distribution of diagnoses between the therapists seem reasonable. Infants are mostly referred by other health personnel but also because of parents' own concern. Based on recommendations, some infants with asymmetries should be examined earlier.

Trial registration: ClinicalTrials.gov Identifier NCT03626389. Registered on August 13th, 2018 (retrospectively registered).

Keywords: Asymmetries; Manual therapy; Motor development; Newborn babies; Physiotherapy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: FYSIOPRIM was approved by the Regional Committee for Medical and Health Research Ethics in Norway (no. 2013/2030) and the present study with its additional data collections, is covered by an extension of the original approval in February 2016. All parents received information and signed informed consent before inclusion of their infant in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. Statistics-Norway. Births https://www.ssb.no/befolkning/fodte-og-dode/statistikk/fodte: Statistics Norway; [updated 07.03.2023; cited 2023 19.12].
    1. Helsedirektoratet. Nasjonal faglig retningslinje for det helsefremmende og forebyggende arbeidet i helsestasjon, skolehelsetjeneste og helsestasjon for ungdom (National Guideline for health promoting and prophylactic work in the public health centre, school health service and public health centre for adolescents) Helsedirektoratet (Norwegian Health Directorate); 2018 [updated 30.6.2023; cited 2023 21.12]. Available from: https://www.helsedirektoratet.no/retningslinjer/helsestasjons-og-skolehe...
    1. Evensen KAI, Sellæg S, Stræte AC, Hansen AE, Meisingset I. Profile of children referred to primary health care physiotherapy: a longitudinal observational study in Norway. BMC Health Serv Res. 2021;21(1):16. - PMC - PubMed
    1. Novak I, Morgan C. High-risk follow-up: early intervention and rehabilitation. Handb Clin Neurol. 2019;162:483–510. - PubMed
    1. van Vlimmeren LA, van der Graaf Y, Boere-Boonekamp MM, L’Hoir MP, Helders PJ, Engelbert RH. Risk factors for deformational Plagiocephaly at birth and at 7 weeks of age: a prospective cohort study. Pediatrics. 2007;119(2):e408–18. - PubMed

Publication types

Associated data