van Vlimmeren Leo A, van der Graaf Yolanda, Boere-Boonekamp Magda M, L'Hoir Monique P, Helders Paul J M, Engelbert Raoul H H
Department of Physical Therapy, Bernhoven Hospital, PO Box 10.000, 5460 DA Veghel, the Netherlands.
Arch Pediatr Adolesc Med. 2008 Aug;162(8):712-8. doi: 10.1001/archpedi.162.8.712.
To study the effect of pediatric physical therapy on positional preference and deformational plagiocephaly.
Randomized controlled trial.
Bernhoven Hospital, Veghel, the Netherlands.
Of 380 infants referred to the examiners at age 7 weeks, 68 (17.9%) met criteria for positional preference, and 65 (17.1%) were enrolled and followed up at ages 6 and 12 months.
Infants with positional preference were randomly assigned to receive either physical therapy (n = 33) or usual care (n = 32).
The primary outcome was severe deformational plagiocephaly assessed by plagiocephalometry. The secondary outcomes were positional preference, motor development, and cervical passive range of motion.
Both groups were comparable at baseline. In the intervention group, the risk for severe deformational plagiocephaly was reduced by 46% at age 6 months (relative risk, 0.54; 95% confidence interval, 0.30-0.98) and 57% at age 12 months (0.43; 0.22-0.85). The numbers of infants with positional preference needed to treat were 3.85 and 3.13 at ages 6 and 12 months, respectively. No infant demonstrated positional preference at follow-up. Motor development was not significantly different between the intervention and usual care groups. Cervical passive range of motion was within the normal range at baseline and at follow-up. When infants were aged 6 months, parents in the intervention group demonstrated significantly more symmetry and less left orientation in nursing, positioning, and handling.
A 4-month standardized pediatric physical therapy program to treat positional preference significantly reduced the prevalence of severe deformational plagiocephaly compared with usual care.
isrctn.org Identifier: ISRCTN84132771.
研究儿科物理治疗对姿势偏好和畸形斜头畸形的影响。
随机对照试验。
荷兰费赫尔的伯恩霍芬医院。
在7周龄时被转诊给检查人员的380名婴儿中，68名（17.9%）符合姿势偏好标准，65名（17.1%）在6个月和12个月龄时被纳入研究并进行随访。
有姿势偏好的婴儿被随机分配接受物理治疗（n = 33）或常规护理（n = 32）。
主要结局是通过斜头测量法评估的严重畸形斜头畸形。次要结局是姿势偏好、运动发育和颈椎被动活动范围。
两组在基线时具有可比性。在干预组中，6个月龄时严重畸形斜头畸形的风险降低了46%（相对风险，0.54；95%置信区间，0.30 - 0.98），12个月龄时降低了57%（0.43；0.22 - 0.85）。6个月和12个月龄时，分别需要治疗3.85名和3.13名有姿势偏好的婴儿。随访时没有婴儿表现出姿势偏好。干预组和常规护理组之间的运动发育没有显著差异。颈椎被动活动范围在基线和随访时均在正常范围内。在婴儿6个月龄时，干预组的父母在护理、放置和处理婴儿时表现出明显更多的对称性和更少的向左倾向。
与常规护理相比，为期4个月的标准化儿科物理治疗方案治疗姿势偏好可显著降低严重畸形斜头畸形的患病率。
isrctn.org标识符：ISRCTN84132771。
