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Updated: Jun 2, 2026
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A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
Is helmet therapy effective in positional plagiocephaly? A systematic review and proposal for an updated management
Daniela Castaño-Bustos1,2, Mariana Agudelo-Arrieta3,4, Maria Isabel Ocampo-Navia3,4
1Neurosurgery Department and Research Group, Pontificia Universidad Javeriana, Bogotá, Colombia. castanodaniela@javeriana.edu.co.
Summary
Positional plagiocephaly management in infants shows helmet therapy may speed early correction for severe cases. However, long-term outcomes are similar to conservative treatments, suggesting helmets accelerate rather than alter final head shape.
Area of Science:
- Pediatrics
- Cranial Morphology
- Infant Health
Background:
- Positional plagiocephaly is a common infant cranial deformity linked to supine sleep recommendations.
- Management strategies, especially cranial orthotic therapy, lack definitive evidence for optimal use.
- Uncertainty exists regarding the timing and effectiveness of interventions for this condition.
Purpose of the Study:
- To systematically review current evidence on therapeutic interventions for positional plagiocephaly.
- To evaluate cranial shape outcomes, treatment response modifiers, and safety profiles.
- To propose an updated management algorithm for individualized clinical decision-making.
Main Methods:
- Systematic review of existing literature on positional plagiocephaly treatments.
- Analysis of studies focusing on cranial asymmetry correction and treatment efficacy.
- Assessment of safety data and factors influencing treatment outcomes.
Main Results:
- Helmet therapy shows faster early correction of cranial asymmetry in moderate-to-severe infant cases.
- Long-term data do not indicate clear superiority of helmet therapy over conservative management.
- Differences in cranial morphology between treatments diminish over time.
Conclusions:
- Cranial orthotic therapy may accelerate correction rate but not fundamentally alter long-term cranial morphology.
- Conservative management remains a viable option, with outcomes comparable to helmet therapy over time.
- An age- and severity-based algorithm is proposed to guide evidence-informed treatment decisions for positional plagiocephaly.
