Customize your JAMA Network experience by selecting one or more topics from the list below.
To study the effect of pediatric physical therapy on positional preference and deformational plagiocephaly.
Randomized controlled trial.
Bernhoven Hospital, Veghel, the Netherlands.
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.
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.
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.
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: http://controlled-trials.com/ISRCTN84132771
van Vlimmeren LA, van der Graaf Y, Boere-Boonekamp MM, L’Hoir MP, Helders PJM, Engelbert RHH. Effect of Pediatric Physical Therapy on Deformational Plagiocephaly in Children With Positional Preference: A Randomized Controlled Trial. Arch Pediatr Adolesc Med. 2008;162(8):712–718. doi:10.1001/archpedi.162.8.712
Create a personal account or sign in to: