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Conservative, helmet therapies effective for positional cranial deformation in infants

Conservative repositioning treatment, with or without physical therapy, and helmet therapy were found to be effective for the correction of positional cranial deformation in a cohort of infants, according to recently published study data.

Researchers assigned 4,378 infant patients with deformational plagiocephaly and/or deformational brachycephaly to conservative (repositioning therapy in 383 patients, repositioning plus physical therapy in 2,998 patients) or helmet therapy (997 patients). Follow-up occurred until patients achieved complete correction, defined as a diagonal difference of less than 5 mm and/or a cranial ratio of less than 0.85, or 18 months. The researchers calculated patients’ rates of correction and identified independent risk factors for failure through the use of multivariate analysis.

Findings showed patients in the helmet therapy group more frequently had deformational plagiocephaly than deformational brachycephaly. Torticollis and developmental delay were also observed to be more prevalent in the helmet group. Additionally, cranial ratio and diagonal difference were significantly more abnormal in the helmet therapy group compared with patients in the conservative treatment groups, according to the researchers.

Complete correction was achieved in 4,062 patients (92.8%). In the conservative group, 77.1% of the 3,381 patients and achieved complete correction with repositioning therapy with or without physical therapy.

A selection of 534 patients were transitioned to helmets based on a lack of improvement with conservative therapy. The remaining 7.1% of conservative therapy patients failed to achieve complete correction with use of same therapy, according to the researchers.

The researchers reported complete correction in 95% of the 1,531 total patients who underwent helmet therapy.

Deformation severity, torticollis after 6 months and neuromuscular development delay were risk factors in addition to age and compliance within the conservative therapy group, whereas the age at initiation of therapy and patient compliance were the only failure risk factors in the helmet therapy group. – by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.