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Effect of pediatric physical therapy on deformational plagiocephaly in children with positional preference: a
Leo A van Vlimmeren1, Yolanda van der Graaf, Magda M Boere-Boonekamp
1Department of Physical Therapy, Bernhoven Hospital, PO Box 10.000, 5460 DA Veghel, the Netherlands. l.vanvlimmeren@bernhoven.nl
Insights
Pediatric physical therapy effectively reduced severe deformational plagiocephaly in infants with positional preference. This treatment significantly lowered the risk of plagiocephaly compared to usual care.
Area of Science:
- Pediatrics
- Physical Therapy
- Developmental Pediatrics
Background:
- Positional preference is common in infants and can lead to deformational plagiocephaly.
- Early intervention is crucial for managing infant head shape abnormalities.
Purpose of the Study:
- To evaluate the efficacy of a standardized pediatric physical therapy program for treating positional preference.
- To assess the impact of this therapy on the development of severe deformational plagiocephaly.
Main Methods:
- A randomized controlled trial was conducted with 65 infants diagnosed with positional preference.
- Infants were assigned to either a physical therapy group or a usual care group.
- Outcomes included severe deformational plagiocephaly, positional preference, motor development, and cervical range of motion.
Main Results:
- Physical therapy significantly reduced the risk of severe deformational plagiocephaly by 46% at 6 months and 57% at 12 months.
- No infants in the physical therapy group exhibited positional preference at follow-up.
- Parents in the intervention group showed improved positioning and handling techniques.
Conclusions:
- A 4-month pediatric physical therapy program is effective in treating positional preference.
- This therapy significantly decreases the prevalence of severe deformational plagiocephaly in infants.
- Early physical therapy intervention offers a beneficial approach for managing positional plagiocephaly.
Objective:
To study the effect of pediatric physical therapy on positional preference and deformational plagiocephaly.
Design:
Randomized controlled trial.
Setting:
Bernhoven Hospital, Veghel, the Netherlands.
Participants:
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.
Intervention:
Infants with positional preference were randomly assigned to receive either physical therapy (n = 33) or usual care (n = 32).
Main Outcome Measures:
The primary outcome was severe deformational plagiocephaly assessed by plagiocephalometry. The secondary outcomes were positional preference, motor development, and cervical passive range of motion.
Results:
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.
Conclusion:
A 4-month standardized pediatric physical therapy program to treat positional preference significantly reduced the prevalence of severe deformational plagiocephaly compared with usual care.
Clinical Trial Registration:
isrctn.org Identifier: ISRCTN84132771.
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