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Efficacy of pediatric integrative manual therapy in positional plagiocephaly: a randomized controlled trial
Iñaki Pastor-Pons1,2, María Orosia Lucha-López3, Marta Barrau-Lalmolda2
1Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009, Zaragoza, Spain.
Insights
Pediatric integrative manual therapy (PIMT) significantly improved cranial vault asymmetry index (CVAI) in infants. PIMT also led to greater parental satisfaction compared to caregiver education alone for positional plagiocephaly.
Area of Science:
- Pediatric physical therapy
- Cranial asymmetry research
- Infant health and development
Background:
- Positional plagiocephaly is a common condition in healthy infants.
- The study investigates the efficacy of manual therapy for improving cranial asymmetry.
Purpose of the Study:
- To compare the effectiveness of pediatric integrative manual therapy (PIMT) combined with caregiver education versus caregiver education alone in treating positional plagiocephaly.
- To assess the impact on cranial shape and parental perception.
Main Methods:
- A randomized controlled trial involving 34 infants under 28 weeks old with cranial diagonal diameter differences of at least 5 mm.
- Intervention group received PIMT plus caregiver education; control group received education only for 10 weeks.
- Cranial shape was measured using anthropometry (CI, CVAI), and parental perception was assessed via visual analogue scale.
Main Results:
- The PIMT group showed a significantly greater decrease in cranial vault asymmetry index (CVAI) compared to the control group (p=0.000).
- Cranial index (CI) did not show significant differences between the groups.
- Parental perception of cranial changes was more positive in the PIMT group (p=0.004).
Conclusions:
- Pediatric integrative manual therapy (PIMT) combined with caregiver education is more effective in improving CVAI than caregiver education alone.
- This combined approach enhances parental satisfaction regarding cranial shape improvements in infants with positional plagiocephaly.
Background:
Positional plagiocephaly frequently affects healthy babies. It is hypothesized that manual therapy tailored to pediatrics is more effective in improving plagiocephalic cranial asymmetry than just repositioning and sensory and motor stimulation.
Methods:
Thirty-four neurologically healthy subjects aged less than 28 weeks old with a difference of at least 5 mm between cranial diagonal diameters were randomly distributed into 2 groups. For 10 weeks, the pediatric integrative manual therapy (PIMT) group received manual therapy plus a caregiver education program, while the controls received the same education program exclusively. Cranial shape was evaluated using anthropometry; cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated. Parental perception of change was assessed using a visual analogue scale (- 10 cm to + 10 cm).
Results:
CVAI presented a greater decrease in PIMT group: 3.72 ± 1.40% compared with 0.34 ± 1.72% in the control group (p = 0.000). CI did not present significant differences between groups. Manual therapy led to a more positive parental perception of cranial changes (manual therapy: 6.66 ± 2.07 cm; control: 4.25 ± 2.31 cm; p = 0.004).
Conclusion:
Manual therapy plus a caregiver education program improved CVAI and led to parental satisfaction more effectively than solely a caregiver education program.
Trial Registration:
Trial registration number: NCT03659032 ; registration date: September 1, 2018. Retrospectively registered.
