Helmet therapy for positional cranial deformations; a 5-year follow-up study

The aim of this study was to assess the long-term effects of helmet therapy in its use for positional cranial deformation, such as plagiocephaly and brachycephaly, by evaluating head shapes in children with a 5-year interval. These children were included at a neonatal age, with a deviating cranial shape classified as positional deformation, and received different forms of therapy, varying from none to physical and helmet therapy combined. Cranial shape was measured before and after therapy, using plagiocephalometry. Both positional plagiocephaly and positional brachycephaly decrease significantly in prevalence and severity over time (P = 0.031 and P < 0.001, respectively), with average relative reductions of 194.5% in ODDI (P = 0.001) and of 878.4% in CPI (P < 0.001). Although the decrease in ODDI and CPI did not significantly vary between treatment methods, ODDI is shown to significantly decrease in case of therapy opposed to no therapy, especially if treatment consists of both physical therapy and helmet therapy (P < 0.001). The long-term effects of therapy are therefore beneficial in the treatment of positional plagiocephaly and will increase the reduction in ODDI, especially in case of both physical and helmet therapy.