Effects of adjunctive craniosacral therapy to conventional physiotherapy on postural responses and autonomic function in individuals with multiple sclerosis: a randomized controlled trial

Background Craniosacral Therapy (CST) has emerged as a complementary approach in neurological rehabilitation, but its effects in multiple sclerosis (MS) remain unclear.Aims To investigate the effects of adding CST to conventional physiotherapy on postural control and autonomic function in patients with MS.Materials and methods Thirty patients with relapsing-remitting MS were randomly assigned to a CST group (n = 15) or control group (n = 15) in this single-blind randomized controlled trial. Both groups received conventional physiotherapy twice weekly for 8 weeks; the CST group additionally received weekly CST. Assessments were conducted at baseline, post-treatment, and 2-month follow-up using Computerized Dynamic Posturography (CDP) and Heart Rate Variability (HRV).Results Significant group × time interactions were found for Adaptation Test (toes-down) and Motor Control Test (back-small) latency measures, with greater reductions in response latency over time in the CST group (ADT toes-down: p = .034, η2 = 0.129; MCT back-small: p = .006, η2 = 0.166). However, no significant between-group differences were observed at any assessment point. For HRV, although the CST group showed within-group improvements after treatment, no significant group × time interactions were detected (all p > .05).Conclusion CST added to conventional physiotherapy may influence specific postural response parameters in patients with MS. However, no between-group superiority was demonstrated, and no significant treatment effect on autonomic function was observed. Further studies with larger samples are needed to confirm these findings.