Use of external orthotic helmet therapy in positional plagiocephaly

• This is the first clinical study on positional plagiocephaly conducted in an Australian population.
• Helmet use leads to greater improvement in asymmetry relative to no therapy in severe cases.
• The reduction in diagonal difference was significant only in those who used helmets.

Positional plagiocephaly is the most common type of cranial asymmetry affecting infants. We aimed to investigate the effectiveness of helmet therapy compared to no helmet therapy in treating positional plagiocephaly in infants under the age of 1 year. This retrospective review was conducted in an Australian paediatric hospital and included 171 patients recruited from outpatient clinics. Only 30 patients had positional plagiocephaly scores recorded at first and final consultations while 39 patients had diagonal measurements recorded at both visits. The mean age was 7.38 months at initial consultation with a mean follow-up duration of 5.85 months. Those who had helmet therapy had a significantly greater reduction in diagonal difference than those who did not use helmets (p = 0.011). Therefore, there may be a role for helmet therapy in the treatment of severe positional plagiocephaly.