Research: Plagiocephaly, Torticollis & Tummy Time

Girolami G, Shiratori T, Aruin A. Anticipatory postural adjustments in children with typical motor development. Experimental Brain Research. 2010; 205:1 53-165.
This study seeks to examine anticipatory postural adjustments (APAs)  role in the performance of activities requiring the maintenance of vertical posture and how children utilize APAs during self-induced postural perturbations.

Hutchison L, Thompson J, Mitchell E. Determinants of nonsynostotic plagiocephaly: A case-control study. Pediatrics. 2003; 112(4): 316-322.
This study concluded that early identification of a favored head orientation, which may indicate the presence of neck muscle dysfunction, may help prevent the development or further development of nonsynostotic plagiocephaly in infants. The study also notes that plagiocephaly may be prevented by varying the head position when putting the infant down to sleep and by giving supervised tummy time when awake.

Kane AA, Mitchell LE, Craven KP, Marsh JL. Observations on a recent increase in plagiocephaly without synostosis. Pediatrics. 1996; 97: 877-885.
As a result of the recent increase in reported cases of plagiocephaly without synostosis (PWS), researchers in this study compared patterns of PWS referrals and referrals for another head deformity called synostotic plagiocephaly over a 16-year study period at a center specializing in head and facial deformities.

Kennedy E, Majnemer A, Farmer JP, Barr RG, Platt RW. Motor development of infants with positional plagiocephaly. Physical & Occupational Therapy in Pediatrics. 2009; 29(3): 222-35.
The purpose of this study was to compare motor development between infants with positional plagiocephaly and matched peers without positional plagiocephaly. Also, researchers examined differences in infant positioning practices when asleep and awake between the two groups. The study found that motor development was associated with amount of time spent on the tummy while awake for both groups of infants. Infants with positional plagiocephaly who spent less time on their tummies while awake had lower motor scores when compared with their matched pairs.

Persing J, James H, Swanson J, Kattwinkel J. Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery & Section on Neurological Surgery. Prevention and management of positional skull deformities in infants. Pediatrics. 2003; 112(1): 199-202.
This report provides guidelines for the prevention, diagnosis, and management of positional plagiocephaly in healthy infants. Pediatricians are advised to properly diagnose skull deformities, educate parents on methods of positional plagiocephaly prevention such as tummy time, initiate appropriate management, and make referrals to a therapist when necessary.

Renske M van Wijk, Leo A van Vlimmeren, Catharina G M Groothuis-Oudshoorn, Catharina P B Van der Ploeg, Maarten J IJzerman. Helmet therapy in infants with positional skull deformation: randomised controlled trial. BMJ. 2014; 348: g2741
The objective of the study was to determine the effectiveness of helmet therapy for positional skull deformation compared with the natural course of the condition in infants aged 5-6 months. The change score for both plagiocephaly and brachycephaly was equal between the helmet therapy and natural course groups. Full recovery was achieved in 10 of 39 (26%) participants in the helmet therapy group and 9 of 40 (23%) participants in the natural course group. All parents reported one or more side effects. The study concluded that based on the equal effectiveness of helmet therapy and skull deformation following its natural course, high prevalence of side effects, and high costs associated with helmet therapy, the use of a helmet as a standard treatment for healthy infants with moderate to severe skull deformation is not recommended.

van Vlimmeren L, van der Graaf Y, Boere-Boonekamp M, L’Hoir M, Helders P, Engelbert R. Effect of pediatric physical therapy on deformational plagiocephaly in children with positional preference: A randomized controlled trial. Archive of Pediatric and Adolescent Medicine. 2008; 162: 712-718.
After studying the effect of pediatric physical therapy on positional and deformational plagiocephaly, researchers found that a 4-month standardized pediatric physical therapy program to treat positional plagiocephaly significantly reduced the prevalence of severe deformational plagiocephaly compared with usual care.