Therapeutic efficacy of individual head orthoses in infants with positional plagiocephaly.

PURPOSE

Regarding the therapy for positional plagiocephaly, a distinction is made between physiotherapeutic-osteopathic treatment and treatment using individual head orthoses. This retrospective study aimed to compare the outcome of these treatment modalities for correcting positional plagiocephaly in infants.

METHODS

From an initial pool of 148 patients, two groups were matched based on age, sex, and Argenta classification. Therapy was either helmet therapy in combination with physiotherapeutic-osteopathic therapy (experimental group/95 patients) or physical therapy alone (control group/28 patients). The helmet was worn 23 h per day and adjusted if necessary. A photo-optical scan was performed pretherapeutically (T0) and posttherapeutically (T1). Besides other parameters, cephalic index (CI) and 30° diagonal difference (DD) were assessed and evaluated statistically. The mean age was 5.4 ± 1.1 months in the experimental group and 5.1 ± 1.0 months in the control group. The sex ratio in the experimental group was 61 males (64.2%) to 34 females (35.8%), and in the control group, it was 19 males (67.9%) to 9 females (32.1%).

RESULTS

After alignment of the groups, the range of correction of DD in the control group (-0.4 mm ± 2.3 mm) was lower than that in the experimental group (-4.8 mm ± 2.8 mm) which was statistically significant (p = 0.001). The control group presented an average CI reduction from T0 to T1 of 0.1% ± 2.1%, while the experimental group showed a significantly higher reduction of CI of 3.6% ± 3.6% (p < 0.001). Treatment time in the helmet therapy group averaged 2.2 ± 0.6 months, and in the control group, it averaged 1.6 ± 0.5 months (p < 0.001).

CONCLUSIONS

In the matched groups, the reduction in CI and DD was significantly greater in the experimental group compared to the control group. Treatment with an individual head orthosis for positional plagiocephaly appears to be more effective than physical treatment alone.