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Therapeutic efficacy of individual head orthoses in infants with positional plagiocephaly
Sachin Chhatwani1, Caterina Degener2, Lucija Rako3
1Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen-Str. 45, 58455, Witten, Germany. sachin.chhatwani@uni-wh.de.
Insights
Helmet therapy combined with physical therapy significantly improved outcomes for positional plagiocephaly in infants compared to physical therapy alone. This approach led to greater reductions in cephalic index and diagonal difference.
Area of Science:
- Pediatric orthopedics
- Cranial deformities
- Infant health
Background:
- Positional plagiocephaly is a common condition in infants.
- Treatment options include physiotherapy-osteopathic therapy and individual head orthoses (helmet therapy).
- Comparative outcome data for these modalities are crucial for clinical decision-making.
Purpose of the Study:
- To compare the effectiveness of helmet therapy combined with physiotherapy versus physiotherapy alone for correcting positional plagiocephaly in infants.
- To evaluate treatment outcomes using cephalic index (CI) and 30° diagonal difference (DD) measurements.
Main Methods:
- A retrospective study comparing two matched groups of infants with positional plagiocephaly.
- Experimental group: Helmet therapy (23 hours/day) plus physiotherapy (95 patients).
- Control group: Physiotherapy alone (28 patients).
- Photo-optical scans were used for pre- and post-treatment assessments (T0 and T1).
Main Results:
- The experimental group showed a significantly greater reduction in DD (-4.8 mm ± 2.8 mm) compared to the control group (-0.4 mm ± 2.3 mm) (p=0.001).
- A significantly higher reduction in CI was observed in the experimental group (3.6% ± 3.6%) versus the control group (0.1% ± 2.1%) (p<0.001).
- Treatment duration averaged 2.2 months for helmet therapy and 1.6 months for physiotherapy alone (p<0.001).
Conclusions:
- Combined helmet therapy and physiotherapy are significantly more effective in correcting positional plagiocephaly than physiotherapy alone.
- Individual head orthoses offer a superior treatment outcome for 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.
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