{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:38:06Z","timestamp":1789180686413,"version":"build-2803163510"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to compare the efficacy of osteopathic manipulative therapy (OMTh) versus light touch therapy (LTT) in reducing cranial asymmetries in infants with nonsynostotic plagiocephaly (NSP).<\/jats:p><jats:p>\n            Study Design\u2003A prospective, parallel-group, single-center, LTT-controlled randomized clinical trial was conducted in the Department of Neonatology of Sant'Anna Hospital in Turin, Italy, from September 6, 2016 to February 20, 2020. We enrolled infants of 1 to 6 months of age with NSP, who were then randomly assigned to the study group (repositioning therapy plus six sessions of OMTh) or the control group (repositioning therapy plus six sessions of LTT). The outcome was the reduction of the oblique diameter difference index (ODDI) score &lt;104%, which was assessed at the end of the intervention protocol (at 3 months) and at 1 year of age.<\/jats:p><jats:p>\n            Results\u2003A total of 96 infants were randomized, 48 in the OMTh group and 48 in the LTT group, with mean ages of 3.1 versus 3.2 months, and baseline ODDI score of 110.2 versus 108.7%. In the OMTh group, a significant reduction of the ODDI score &lt;104%, compared with the LTT group, was observed in the intension-to-treat (ITT) and per-protocol (PP) analyses. The ITT analysis revealed an ODDI score &lt;104% in the OMTh group at 3 months (risk difference: 0.41; 95% confidence interval [CI]: 0.25\u20130.53; p\u2009&lt;\u20090.001) and at the follow-up at 1 year of age (risk difference: 0.47; 95% CI: 0.31\u20130.64; p\u2009&lt;\u20090.001). The PP analysis at 3 months reported a risk difference of 0.44 (95% CI: 0.27\u20130.60; p\u2009&lt;\u20090.001), and at 1 year of age, a risk difference of 0.54 (95% CI: 0.36\u20130.72; p\u2009&lt;\u20090.001).<\/jats:p><jats:p>\n            Conclusion\u2003In infants with NSP, a course of six OMTh sessions significantly reduced cranial asymmetries at both the 3-month and 1-year follow-up assessments, compared with LTT. This study is registered with ClinicalTrial.gov (identifier: NCT03970395; \n              www.clinicaltrials.gov\n            ).<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0042-1758723","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T07:17:46Z","timestamp":1669879066000},"page":"S52-S62","source":"Crossref","is-referenced-by-count":12,"special_numbering":"S","title":["A Randomized Controlled Trial of Osteopathic Manipulative Therapy to Reduce Cranial Asymmetries in Young Infants with Nonsynostotic Plagiocephaly"],"prefix":"10.1055","volume":"39","author":[{"given":"Donatella","family":"Bagagiolo","sequence":"additional","affiliation":[{"name":"Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio G.","family":"Priolo","sequence":"additional","affiliation":[{"name":"Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena M.","family":"Favre","sequence":"additional","affiliation":[{"name":"Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Pangallo","sequence":"additional","affiliation":[{"name":"Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Didio","sequence":"additional","affiliation":[{"name":"Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Sbarbaro","sequence":"additional","affiliation":[{"name":"Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Borro","sequence":"additional","affiliation":[{"name":"Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Dacc\u00f2","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"},{"name":"Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Albese con Cassano, Como, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Manzoni","sequence":"additional","affiliation":[{"name":"Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy"},{"name":"Division of Pediatrics and Neonatology, Department of Maternal, Neonatal, and Infant Medicine, Nuovo Ospedale Degli Infermi, Ponderano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Farina","sequence":"additional","affiliation":[{"name":"Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.pedhc.2011.10.002","article-title":"Evidence-based care of the child with deformational plagiocephaly, part II: management","volume":"26","author":"A BK Flannery","year":"2012","journal-title":"J Pediatr Heal Care"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.pedhc.2011.10.003","article-title":"Evidence-based care of the child with deformational plagiocephaly, part I: assessment and diagnosis","volume":"26","author":"W S Looman","year":"2012","journal-title":"J Pediatr Heal Care"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1136\/archdischild-2016-312018","article-title":"Deformational plagiocephaly in normal infants: a systematic review of causes and hypotheses","volume":"102","author":"F De Bock","year":"2017","journal-title":"Arch Dis Child"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"e20162940","DOI":"10.1542\/peds.2016-2940","article-title":"SIDS and other sleep-related infant deaths: evidence base for 2016 updated recommendations for a safe infant sleeping environment","volume":"138","author":"R Y Moon","year":"2016","journal-title":"Pediatrics"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1542\/peds.107.2.339","article-title":"Positional preference: prevalence in infants and follow-up after two years","volume":"107","author":"M M Boere-Boonekamp","year":"2001","journal-title":"Pediatrics"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1007\/s00431-018-3212-0","article-title":"Prevalence and characteristics of positional plagiocephaly in healthy full-term infants at 8-12 weeks of life","volume":"177","author":"E Ballardini","year":"2018","journal-title":"Eur J Pediatr"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"e408","DOI":"10.1542\/peds.2006-2012","article-title":"Risk factors for deformational plagiocephaly at birth and at 7 weeks of age: a prospective cohort study","volume":"119","author":"L A van Vlimmeren","year":"2007","journal-title":"Pediatrics"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1542\/peds.2003-0668-F","article-title":"Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study","volume":"114","author":"B L Hutchison","year":"2004","journal-title":"Pediatrics"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"434","DOI":"10.23736\/S0390-5616.20.04841-9","article-title":"Cognitive characteristics of children treated for deformational plagiocephaly and parental perception of the therapy","volume":"66","author":"D Pawelczak","year":"2022","journal-title":"J Neurosurg Sci"},{"issue":"08","key":"ref10","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/j.1469-8749.2008.03029.x","article-title":"Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review","volume":"50","author":"A E Bialocerkowski","year":"2008","journal-title":"Dev Med Child Neurol"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1007\/s00381-011-1493-y","article-title":"Positional plagiocephaly: what the pediatrician needs to know. A review","volume":"27","author":"L Pogliani","year":"2011","journal-title":"Childs Nerv Syst"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/00004703-200510000-00008","article-title":"Neurodevelopmental implications of \u201cdeformational\u201d plagiocephaly","volume":"26","author":"B Collett","year":"2005","journal-title":"J Dev Behav Pediatr"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1111\/j.1365-3016.2009.01038.x","article-title":"A case-control study of infant, maternal and perinatal characteristics associated with deformational plagiocephaly","volume":"23","author":"C M McKinney","year":"2009","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"03","key":"ref14","first-page":"e537","article-title":"Case-control study of neurodevelopment in deformational plagiocephaly. Pediatrics","volume":"125","author":"M L Speltz","year":"2010"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1111\/jpc.13155","article-title":"Repercussions of plagiocephaly on posture, muscle flexibility and balance in children aged 3\u20135 years old","volume":"52","author":"I Cabrera-Martos","year":"2016","journal-title":"J Paediatr Child Health"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1542\/peds.2011-2220","article-title":"Prevention and management of positional skull deformities in infants","volume":"128","author":"J Laughlin","year":"2011","journal-title":"Pediatrics"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"E630","DOI":"10.1227\/NEU.0000000000001429","article-title":"Congress of Neurological Surgeons systematic review and evidence-based guideline for the Management of Patients with Positional Plagiocephaly: the role of physical therapy","volume":"79","author":"L C Baird","year":"2016","journal-title":"Neurosurgery"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"E632","DOI":"10.1227\/NEU.0000000000001430","article-title":"Congress of Neurological Surgeons systematic review and evidence-based guideline on the role of cranial molding Orthosis (helmet) therapy for patients with positional Plagiocephaly","volume":"79","author":"M S Tamber","year":"2016","journal-title":"Neurosurgery"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"101277","DOI":"10.1016\/j.ctcp.2020.101277","article-title":"The role of touch in osteopathic practice: a narrative review and integrative hypothesis","volume":"42","author":"F Baroni","year":"2021","journal-title":"Complement Ther Clin Pract"},{"issue":"01","key":"ref20","first-page":"28","article-title":"International overview of somatic dysfunction assessment and treatment in osteopathic research: a scoping review","volume":"10","author":"M Tramontano","year":"2021","journal-title":"Helthcare (Basel)"},{"issue":"04","key":"ref21","doi-asserted-by":"crossref","first-page":"e053468","DOI":"10.1136\/bmjopen-2021-053468","article-title":"Efficacy and safety of osteopathic manipulative treatment: an overview of systematic reviews","volume":"12","author":"D Bagagiolo","year":"2022","journal-title":"BMJ Open"},{"issue":"11","key":"ref22","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1055\/s-0036-1586113","article-title":"Osteopathic manipulative treatment in pediatric and neonatal patients and disorders: clinical considerations and updated review of the existing literature","volume":"33","author":"D Bagagiolo","year":"2016","journal-title":"Am J Perinatol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jbmt.2022.03.013","article-title":"Effectiveness of osteopathic manipulative treatment for pediatric conditions: a systematic review","volume":"31","author":"H Franke","year":"2022","journal-title":"J Bodyw Mov Ther"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.ctcp.2011.02.001","article-title":"Exploring the impact of osteopathic treatment on cranial asymmetries associated with nonsynostotic plagiocephaly in infants","volume":"17","author":"S Lessard","year":"2011","journal-title":"Complement Ther Clin Pract"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"340","author":"K F Schulz","year":"2010","journal-title":"BMJ"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s00431-005-0011-1","article-title":"Plagiocephalometry: a non-invasive method to quantify asymmetry of the skull; a reliability study","volume":"165","author":"L A van Vlimmeren","year":"2006","journal-title":"Eur J Pediatr"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1371\/journal.pmed.0040061","article-title":"Reporting methods of blinding in randomized trials assessing nonpharmacological treatments","volume":"4","author":"I Boutron","year":"2007","journal-title":"PLoS Med"},{"issue":"05","key":"ref29","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1227\/NEU.0000000000001426","article-title":"Congress of Neurological Surgeons systematic review and evidence-based guidelines for the management of patients with positional plagiocephaly: executive summary","volume":"79","author":"A M Flannery","year":"2016","journal-title":"Neurosurgery"},{"key":"ref30","volume-title":"Glossary of Osteopathic Terminology","author":"R Giusti","year":"2017","edition":"3rd ed. PDF Edi"},{"issue":"09","key":"ref31","first-page":"508","article-title":"Clinical and research protocol for osteopathic manipulative treatment of elderly patients with pneumonia","volume":"108","author":"D R Noll","year":"2008","journal-title":"J Am Osteopath Assoc"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"g2741","DOI":"10.1136\/bmj.g2741","article-title":"Helmet therapy in infants with positional skull deformation: randomised controlled trial","volume":"348","author":"R M Van Wijk","year":"2014","journal-title":"BMJ"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"e2021051736","DOI":"10.1542\/peds.2021-051736","article-title":"Novel screening and monitoring techniques for deformational plagiocephaly: a systematic review","volume":"149","author":"A Watt","year":"2022","journal-title":"Pediatrics"},{"issue":"08","key":"ref35","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1001\/archpedi.162.8.712","article-title":"Effect of pediatric physical therapy on deformational plagiocephaly in children with positional preference: a randomized controlled trial","volume":"162","author":"L A van Vlimmeren","year":"2008","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"09","key":"ref36","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1007\/s00381-015-2769-4","article-title":"Long-term outcomes in treatment of deformational plagiocephaly and brachycephaly using helmet therapy and repositioning: a longitudinal cohort study","volume":"31","author":"S D Naidoo","year":"2015","journal-title":"Childs Nerv Syst"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s12998-020-00321-w","article-title":"The effectiveness and safety of conservative interventions for positional plagiocephaly and congenital muscular torticollis: a synthesis of systematic reviews and guidance","volume":"28","author":"J Ellwood","year":"2020","journal-title":"Chiropr Man Therap"},{"issue":"02","key":"ref38","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jcms.2015.11.016","article-title":"Impact of severity and therapy onset on helmet therapy in positional plagiocephaly","volume":"44","author":"C Freudlsperger","year":"2016","journal-title":"J Craniomaxillofac Surg"},{"issue":"04","key":"ref39","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jcms.2011.05.007","article-title":"Complications in helmet therapy","volume":"40","author":"J-F Wilbrand","year":"2012","journal-title":"J Craniomaxillofac Surg"},{"issue":"01","key":"ref40","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00431-016-2800-0","article-title":"The course of skull deformation from birth to 5 years of age: a prospective cohort study","volume":"176","author":"L A van Vlimmeren","year":"2017","journal-title":"Eur J Pediatr"},{"issue":"12","key":"ref41","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.earlhumdev.2013.08.011","article-title":"Prevalence of head deformities in preterm infants at term equivalent age","volume":"89","author":"S Ifflaender","year":"2013","journal-title":"Early Hum Dev"},{"issue":"06","key":"ref42","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.earlhumdev.2011.10.001","article-title":"Prevalence and predictors of idiopathic asymmetry in infants born preterm","volume":"88","author":"J Nuysink","year":"2012","journal-title":"Early Hum Dev"},{"issue":"03","key":"ref43","doi-asserted-by":"crossref","first-page":"658.e1","DOI":"10.1016\/j.jpeds.2013.04.015","article-title":"Clinical course of asymmetric motor performance and deformational plagiocephaly in very preterm infants","volume":"163","author":"J Nuysink","year":"2013","journal-title":"J Pediatr"},{"issue":"05","key":"ref44","doi-asserted-by":"crossref","first-page":"e0127370","DOI":"10.1371\/journal.pone.0127370","article-title":"A multicenter, randomized, controlled trial of osteopathic manipulative treatment on preterms","volume":"10","author":"F Cerritelli","year":"2015","journal-title":"PLoS One"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"g1687","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide","volume":"348","author":"T C Hoffmann","year":"2014","journal-title":"BMJ"},{"issue":"07","key":"ref46","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1097\/SCS.0000000000005665","article-title":"Treatment of deformational plagiocephaly with physiotherapy","volume":"30","author":"A Di Chiara","year":"2019","journal-title":"J Craniofac Surg"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1758723.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T02:17:55Z","timestamp":1671502675000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1758723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,30]]},"references-count":44,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2022,12,19]]},"published-print":{"date-parts":[[2022,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1758723","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,30]]}}}