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Arch Pediatr Adolesc Med. 2008 Aug;162(8):712-8. doi: 10.1001/archpedi.162.8.712.

Effect of pediatric physical therapy on deformational plagiocephaly in children with positional preference: a randomized controlled trial.

Author information

1
Department of Physical Therapy, Bernhoven Hospital, PO Box 10.000, 5460 DA Veghel, the Netherlands. l.vanvlimmeren@bernhoven.nl

Abstract

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.

PMID:
18678802
DOI:
10.1001/archpedi.162.8.712
[Indexed for MEDLINE]

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