OBJECTIVE: To study the effect of pediatric physical therapy on positional preference and deformational plagiocephaly. DESIGN: Randomized controlled trial. SETTING: Bernhoven Hospital, Veghel, the Netherlands. PARTICIPANTS: Of 380 infants referred to the examiners at age 7 weeks, 68 (17.9%) met criteria for positional preference, and 65 (17.1%) were enrolled and followed up at ages 6 and 12 months. INTERVENTION: Infants with positional preference were randomly assigned to receive either physical therapy (n = 33) or usual care (n = 32). MAIN OUTCOME MEASURES: The primary outcome was severe deformational plagiocephaly assessed by plagiocephalometry. The secondary outcomes were positional preference, motor development, and cervical passive range of motion. RESULTS: Both groups were comparable at baseline. In the intervention group, the risk for severe deformational plagiocephaly was reduced by 46% at age 6 months (relative risk, 0.54; 95% confidence interval, 0.30-0.98) and 57% at age 12 months (0.43; 0.22-0.85). The numbers of infants with positional preference needed to treat were 3.85 and 3.13 at ages 6 and 12 months, respectively. No infant demonstrated positional preference at follow-up. Motor development was not significantly different between the intervention and usual care groups. Cervical passive range of motion was within the normal range at baseline and at follow-up. When infants were aged 6 months, parents in the intervention group demonstrated significantly more symmetry and less left orientation in nursing, positioning, and handling. CONCLUSION: A 4-month standardized pediatric physical therapy program to treat positional preference significantly reduced the prevalence of severe deformational plagiocephaly compared with usual care. CLINICAL TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN84132771.
RCT Entities:
OBJECTIVE: To study the effect of pediatric physical therapy on positional preference and deformational plagiocephaly. DESIGN: Randomized controlled trial. SETTING: Bernhoven Hospital, Veghel, the Netherlands. PARTICIPANTS: Of 380 infants referred to the examiners at age 7 weeks, 68 (17.9%) met criteria for positional preference, and 65 (17.1%) were enrolled and followed up at ages 6 and 12 months. INTERVENTION: Infants with positional preference were randomly assigned to receive either physical therapy (n = 33) or usual care (n = 32). MAIN OUTCOME MEASURES: The primary outcome was severe deformational plagiocephaly assessed by plagiocephalometry. The secondary outcomes were positional preference, motor development, and cervical passive range of motion. RESULTS: Both groups were comparable at baseline. In the intervention group, the risk for severe deformational plagiocephaly was reduced by 46% at age 6 months (relative risk, 0.54; 95% confidence interval, 0.30-0.98) and 57% at age 12 months (0.43; 0.22-0.85). The numbers of infants with positional preference needed to treat were 3.85 and 3.13 at ages 6 and 12 months, respectively. No infant demonstrated positional preference at follow-up. Motor development was not significantly different between the intervention and usual care groups. Cervical passive range of motion was within the normal range at baseline and at follow-up. When infants were aged 6 months, parents in the intervention group demonstrated significantly more symmetry and less left orientation in nursing, positioning, and handling. CONCLUSION: A 4-month standardized pediatric physical therapy program to treat positional preference significantly reduced the prevalence of severe deformational plagiocephaly compared with usual care. CLINICAL TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN84132771.
Authors: I Cabrera-Martos; M C Valenza; A Benítez-Feliponi; C Robles-Vizcaíno; A Ruiz-Extremera; G Valenza-Demet Journal: Childs Nerv Syst Date: 2013-05-05 Impact factor: 1.475
Authors: Henri Aarnivala; Ville Vuollo; Virpi Harila; Tuomo Heikkinen; Pertti Pirttiniemi; Lasse Holmström; A Marita Valkama Journal: Eur J Pediatr Date: 2016-09-13 Impact factor: 3.183
Authors: I Cabrera-Martos; M C Valenza; G Valenza-Demet; A Benítez-Feliponi; C Robles-Vizcaíno; A Ruiz-Extremera Journal: Childs Nerv Syst Date: 2016-07-27 Impact factor: 1.475