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A prospective randomized trial on preventative methods for positional head deformity: physiotherapy versus a
Jan-Falco Wilbrand1, Maximilian Seidl, Martina Wilbrand
1Department of Cranio-Maxillofacial Surgery, University Hospital Giessen, Giessen, Germany. jan-falco.wilbrand@uniklinikum-giessen.de
Insights
Both bedding pillows and stretching exercises improve positional head deformities in infants. Bedding pillows showed slightly greater improvement for combined plagiocephaly and brachycephaly.
Area of Science:
- Pediatric orthopedics
- Craniofacial abnormalities
Background:
- Positional head deformities are common in infants.
- Early intervention is crucial for optimal outcomes.
Purpose of the Study:
- To compare the effectiveness of bedding pillows versus stretching exercises for treating positional head deformities in infants.
Main Methods:
- A prospective clinical trial included 50 infants (≤5 months) with plagiocephaly, brachycephaly, or combined deformities.
- Infants were randomized to receive either bedding pillows or stretching exercises for 6 weeks.
- Cranial vault asymmetry index (CVAI) and cranial index (CI) were measured before and after treatment.
Main Results:
- Both interventions improved cranial deformities.
- Stretching exercises showed ΔCVAI of 2.09% (plagiocephaly) and 2.34% (combined).
- Bedding pillows showed ΔCVAI of 3.01% (plagiocephaly) and 2.86% (combined).
- Stretching exercises showed ΔCI of 0.94% (brachycephaly) and 2.24% (combined).
- Bedding pillows showed ΔCI of 3.63% (brachycephaly) and 3.23% (combined).
Conclusions:
- Both bedding pillows and stretching exercises are effective treatments for positional cranial deformation.
- Bedding pillows demonstrated a slightly greater improvement in cranial asymmetry for combined deformities.
Objective:
To evaluate the impact of stretching exercises versus available bedding pillows on positional head deformities.
Study Design:
Fifty children aged 5 months or younger with positional head deformity were included in this prospective clinical trial (n=20 plagiocephaly, n=10 brachycephaly, n=20 combination). A random distribution was performed for treatment with the bedding pillow alone (n=25) or with stretching exercises (n=25) for 6 weeks. Anthropometric caliper measurements were done before and after that interval. Cranial vault asymmetry index (CVAI) and cranial index (CI) were calculated and analyzed using a descriptive statistical general linear model.
Results:
ΔCVAI in the stretching group was 2.09% for plagiocephaly and 2.34% for combined head deformities. Using the bedding pillow, ΔCVAI was 3.01% in plagiocephal children and 2.86% for combined head deformity. The ΔCI in the stretching group was 0.94% for isolated brachycephal children and 2.24% for combined head deformity. ΔCI in the pillow group was 3.63% for brachycephaly and 3.23% in children with combined head deformities, respectively.
Conclusions:
Bedding pillows and stretching exercises both resulted in improvements in positional cranial deformation. For children with combined plagiocephaly and brachycephaly, improvement in cranial asymmetry was slightly greater when using bedding pillows versus stretching.
