Therapy effects of head orthoses in positional plagiocephaly

Head orthoses offer a valuable therapeutic option for infants with positional plagiocephaly. The aim of this retrospective study was to evaluate the influence of therapy start and duration due to improvement of cranial asymmetry.

A total of 102 children during the years 2009-2014 were included. The patient cohort was divided according to age at the beginning of therapy (younger/older than 7.5 months) and duration (less/more than 150 days). To evaluate the therapy, ear shift (ES), Cranial Vault Asymmetry Index (CVAI), and Cranial Index (CI) were calculated pre- and post-therapy by using three-dimensional photogrammetry measurements.

Treatment with head orthoses led to a significant reduction of CVAI in groups with less and more than 150 days of therapy (p < 0.0001). A significant reduction in CVAI was observed (p = 0.0235) in children younger than 7.5 months in short-term therapy. At the end of therapy, no significant difference was found in the groups, whether treated with short- or long-term head orthoses (p = 0.0813), although CVAI was significantly different comparing the third time point of both groups for treatment duration (p = 0.017). The major positive effect of helmet therapy has been seen after 75 days of treatment. A treatment that was longer than 150 days did not show any significant improvement concerning the cranial asymmetry.

Helmet therapy is a reliable method in the treatment of positional plagiocephaly to improve cephalic asymmetries. This retrospective study indicates that an early beginning can lead to satisfying results after short-term therapy.