{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:46:26Z","timestamp":1791377186292,"version":"4.3.2"},"reference-count":86,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>The goal of this study was to review the current literature on orthotic (helmet) therapy use in the treatment of deformational plagiocephaly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed was used to search English articles using the medical subject headings \u201cdeformational plagiocephaly\u201d and \u201corthosis,\u201d and \u201cdeformational plagiocephaly\u201d and \u201chelmet.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-two articles were found. There were no Class I studies, 7 Class II studies, 1 Class III study, and 13 Class IV studies. Cranial orthoses have been shown to be effective in treating deformational plagiocephaly. It continues to be debated as to whether the statistical significance of treatment with cranial orthoses compared with conservative therapies is clinically significant. Children older than 12 months of age with deformational plagiocephaly may still benefit from orthotic therapy. The long-term effects of orthotic therapy are controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a lack of Class I literature evidence supporting the use of helmet therapy in deformational plagiocephaly. There are controversies surrounding the use of orthotic therapy such as appropriate use, cost, use in older children, and long-term outcomes. Clinical indications for orthotic therapy need to be better defined with further research studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2013.7.focus13260","type":"journal-article","created":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T08:33:12Z","timestamp":1380616392000},"page":"E2","source":"Crossref","is-referenced-by-count":23,"title":["Orthotic (helmet) therapy in the treatment of plagiocephaly"],"prefix":"10.3171","volume":"35","author":[{"given":"Jo Ling","family":"Goh","sequence":"first","affiliation":[{"name":"Geisel School of Medicine, Hanover; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R.","family":"Durham","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell A.","family":"Stotland","sequence":"additional","affiliation":[{"name":"Plastic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0350002","series-title":"J Craniofac Surg","first-page":"5","article-title":"An increase in infant cranial deformity with supine sleeping position","volume":"7","author":"Argenta","year":"1996"},{"issue":"6","key":"b2-0350002","series-title":"Neurosurg Focus","first-page":"E1","article-title":"The sociopolitical history and physiological underpinnings of skull deformation","volume":"29","author":"Ayer","year":"2010"},{"key":"b3-0350002","series-title":"Arch Dis Child","first-page":"809","article-title":"Head moulding for plagiocephaly","volume":"93","author":"Carter","year":"2008"},{"key":"b4-0350002","series-title":"J Pediatr","first-page":"43","article-title":"Helmet treatment for plagiocephaly and congenital muscular torticollis","volume":"94","author":"Clarren","year":"1979"},{"key":"b5-0350002","series-title":"Swiss Med Wkly","first-page":"368","article-title":"Posterior positional plagiocephaly treated with cranial remodeling orthosis","volume":"137","author":"de Ribaupierre","year":"2007"},{"key":"b6-0350002","series-title":"Cleft Palate Craniofac J","first-page":"340","article-title":"Parental satisfaction with the CranioCap: a new cranial orthosis for deformational plagiocephaly","volume":"42","author":"Elwood","year":"2005"},{"key":"b7-0350002","series-title":"J Pediatr Health Care","first-page":"320","article-title":"Evidence-based care of the child with deformational plagiocephaly, part II: management","volume":"26","author":"Flannery","year":"2012"},{"key":"b8-0350002","series-title":"Arch Dis Child","first-page":"805","article-title":"Plagiocephaly, brachycephaly and cranial orthotic devices: misshapen heads and helmets","volume":"93","author":"Gill","year":"2008"},{"key":"b9-0350002","series-title":"J Craniofac Surg","first-page":"56","article-title":"Molding therapy of positional plagiocephaly: subjective outcome and quality of life","volume":"19","author":"Govaert","year":"2008"},{"key":"b10-0350002","series-title":"J Pediatr","first-page":"258","article-title":"Management of deformational plagiocephaly: repositioning versus orthotic therapy","volume":"146","author":"Graham","year":"2005"},{"key":"b11-0350002","series-title":"J Pediatr","first-page":"253","article-title":"Deformational brachycephaly in supine-sleeping infants","volume":"146","author":"Graham","year":"2005"},{"key":"b12-0350002","series-title":"Plast Reconstr Surg","first-page":"19e","article-title":"Real versus perceived improvements of helmet molding therapy for the treatment of plagiocephaly","volume":"126","author":"Katzel","year":"2010"},{"key":"b13-0350002","series-title":"Plast Reconstr Surg","first-page":"492","article-title":"What is the optimal time to start helmet therapy in positional plagiocephaly?","volume":"128","author":"Kluba","year":"2011"},{"key":"b14-0350002","series-title":"J Craniofac Surg","first-page":"1301","article-title":"Does helmet therapy influence the ear shift in positional plagiocephaly?","volume":"23","author":"Kluba","year":"2012"},{"key":"b15-0350002","series-title":"Cleft Palate Craniofac J","first-page":"240","article-title":"Long-term treatment effectiveness of molding helmet therapy in the correction of posterior deformational plagiocephaly: a five-year follow-up","volume":"45","author":"Lee","year":"2008"},{"key":"b16-0350002","series-title":"J Craniofac Surg","first-page":"139","article-title":"A pneumatic orthotic cranial molding helmet for correcting positional plagiocephaly","volume":"17","author":"Lee","year":"2006"},{"key":"b17-0350002","series-title":"Pediatrics","first-page":"e936","article-title":"Helmet versus active repositioning for plagiocephaly: a three-dimensional analysis","volume":"126","author":"Lipira","year":"2010"},{"key":"b18-0350002","series-title":"J Neurosurg Pediatr","first-page":"219","article-title":"Deformational plagiocephaly","volume":"2","author":"Littlefield","year":"2010"},{"issue":"4S","key":"b19-0350002","series-title":"J Prosthet Orthot","first-page":"35","article-title":"FDA regulation of cranial remodeling devices","volume":"16","author":"Littlefield","year":"2004"},{"issue":"3","key":"b20-0350002","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Dynamic orthotic cranioplasty: treatment of the older infant. Report of four cases","volume":"9","author":"Littlefield","year":"2000"},{"key":"b21-0350002","series-title":"Semin Pediatr Neurol","first-page":"301","article-title":"On the current incidence of deformational plagiocephaly: an estimation based on prospective registration at a single center","volume":"11","author":"Littlefield","year":"2004"},{"key":"b22-0350002","series-title":"J Pediatr Health Care","first-page":"242","article-title":"Evidence-based care of the child with deformational plagiocephaly, Part I: assessment and diagnosis","volume":"26","author":"Looman","year":"2012"},{"key":"b23-0350002","series-title":"Plast Reconstr Surg","first-page":"1866","article-title":"Nonsynostotic occipital plagiocephaly: factors impacting onset, treatment, and outcomes","volume":"119","author":"Losee","year":"2007"},{"key":"b24-0350002","series-title":"Dev Med Child Neurol","first-page":"568","article-title":"Head shape measurement standards and cranial orthoses in the treatment of infants with deformational plagiocephaly","volume":"50","author":"McGarry","year":"2008"},{"key":"b25-0350002","series-title":"J Orofac Orthop","first-page":"151","article-title":"Head orthesis therapy in infants with unilateral positional plagiocephaly: an interdisciplinary approach to broadening the range of orthodontic treatment","volume":"73","author":"Meyer-Marcotty","year":"2012"},{"key":"b26-0350002","series-title":"Childs Nerv Syst","first-page":"1407","article-title":"Deformational plagiocephaly and orthotic treatment: indications and limitations","volume":"28","author":"Mortenson","year":"2012"},{"key":"b27-0350002","series-title":"J Neurosurg","first-page":"667","article-title":"Nonsurgical, nonorthotic treatment of occipital plagiocephaly: what is the natural history of the misshapen neonatal head?","volume":"87","author":"Moss","year":"1997"},{"key":"b28-0350002","series-title":"Plast Reconstr Surg","first-page":"371","article-title":"Analysis of posterior plagiocephaly: deformational versus synostotic","volume":"103","author":"Mulliken","year":"1999"},{"key":"b29-0350002","series-title":"Clin Pediatr (Phila)","first-page":"292","article-title":"The infant with a misshapen head","volume":"46","author":"Nield","year":"2007"},{"key":"b30-0350002","series-title":"Community Pract","first-page":"38","article-title":"Plagiocephaly and awareness, prevention and treatment","volume":"81","author":"Otway","year":"2008"},{"key":"b31-0350002","series-title":"J Craniofac Surg","first-page":"1084","article-title":"Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer","volume":"17","author":"Plank","year":"2006"},{"key":"b32-0350002","series-title":"J Neurosurg Pediatr","first-page":"284","article-title":"Diagnosis and management of deformational plagiocephaly. A review","volume":"3","author":"Robinson","year":"2009"},{"key":"b33-0350002","series-title":"Plast Reconstr Surg","first-page":"941","article-title":"Comparison of a modifiable cranial cup versus repositioning and cervical stretching for the early correction of deformational posterior plagiocephaly","volume":"121","author":"Rogers","year":"2008"},{"key":"b34-0350002","series-title":"Arch Dis Child","first-page":"82","article-title":"Management of positional plagiocephaly","volume":"93","author":"Saeed","year":"2008"},{"key":"b35-0350002","series-title":"J Craniofac Surg","first-page":"1677","article-title":"Three-dimensional photographic analysis of outcome after helmet treatment of a nonsynostotic cranial deformity","volume":"21","author":"Schaaf","year":"2010"},{"key":"b36-0350002","series-title":"Plast Reconstr Surg","first-page":"55e","article-title":"Helmet treatment of deformational plagiocephaly: the relationship between age at initiation and rate of correction","volume":"131","author":"Seruya","year":"2013"},{"key":"b37-0350002","series-title":"Clin Invest Med","first-page":"E266","article-title":"Cosmetic and cognitive outcomes of positional plagiocephaly treatment","volume":"35","author":"Shamji","year":"2012"},{"key":"b38-0350002","series-title":"Arch Dis Child","first-page":"807","article-title":"What is the role of helmet therapy in positional plagiocephaly?","volume":"93","author":"Singh","year":"2008"},{"key":"b39-0350002","series-title":"Childs Nerv Syst","first-page":"1275","article-title":"Longterm outcome of infants with positional occipital plagiocephaly","volume":"23","author":"Steinbok","year":"2007"},{"key":"b40-0350002","series-title":"J Craniofac Surg","first-page":"399","article-title":"Deformational plagiocephaly associated with ocular torticollis: a clinical study and literature review","volume":"18","author":"Stevens","year":"2007"},{"key":"b41-0350002","series-title":"J Craniofac Surg","first-page":"362","article-title":"Outcome analysis of helmet therapy for positional plagiocephaly using a three-dimensional surface scanning laser","volume":"20","author":"Thompson","year":"2009"},{"key":"b42-0350002","series-title":"Pediatr Rehabil","first-page":"40","article-title":"Torticollis and plagiocephaly in infancy: therapeutic strategies","volume":"9","author":"van Vlimmeren","year":"2006"},{"key":"b43-0350002","series-title":"Trials","first-page":"108","article-title":"HElmet therapy Assessment in infants with Deformed Skulls (HEADS): protocol for a randomised controlled trial","volume":"13","author":"van Wijk","year":"2012"},{"key":"b1-0350002","series-title":"J Craniofac Surg","first-page":"5","article-title":"An increase in infant cranial deformity with supine sleeping position","volume":"7","author":"Argenta","year":"1996"},{"issue":"6","key":"b2-0350002","series-title":"Neurosurg Focus","first-page":"E1","article-title":"The sociopolitical history and physiological underpinnings of skull deformation","volume":"29","author":"Ayer","year":"2010"},{"key":"b3-0350002","series-title":"Arch Dis Child","first-page":"809","article-title":"Head moulding for plagiocephaly","volume":"93","author":"Carter","year":"2008"},{"key":"b4-0350002","series-title":"J Pediatr","first-page":"43","article-title":"Helmet treatment for plagiocephaly and congenital muscular torticollis","volume":"94","author":"Clarren","year":"1979"},{"key":"b5-0350002","series-title":"Swiss Med Wkly","first-page":"368","article-title":"Posterior positional plagiocephaly treated with cranial remodeling orthosis","volume":"137","author":"de Ribaupierre","year":"2007"},{"key":"b6-0350002","series-title":"Cleft Palate Craniofac J","first-page":"340","article-title":"Parental satisfaction with the CranioCap: a new cranial orthosis for deformational plagiocephaly","volume":"42","author":"Elwood","year":"2005"},{"key":"b7-0350002","series-title":"J Pediatr Health Care","first-page":"320","article-title":"Evidence-based care of the child with deformational plagiocephaly, part II: management","volume":"26","author":"Flannery","year":"2012"},{"key":"b8-0350002","series-title":"Arch Dis Child","first-page":"805","article-title":"Plagiocephaly, brachycephaly and cranial orthotic devices: misshapen heads and helmets","volume":"93","author":"Gill","year":"2008"},{"key":"b9-0350002","series-title":"J Craniofac Surg","first-page":"56","article-title":"Molding therapy of positional plagiocephaly: subjective outcome and quality of life","volume":"19","author":"Govaert","year":"2008"},{"key":"b10-0350002","series-title":"J Pediatr","first-page":"258","article-title":"Management of deformational plagiocephaly: repositioning versus orthotic therapy","volume":"146","author":"Graham","year":"2005"},{"key":"b11-0350002","series-title":"J Pediatr","first-page":"253","article-title":"Deformational brachycephaly in supine-sleeping infants","volume":"146","author":"Graham","year":"2005"},{"key":"b12-0350002","series-title":"Plast Reconstr Surg","first-page":"19e","article-title":"Real versus perceived improvements of helmet molding therapy for the treatment of plagiocephaly","volume":"126","author":"Katzel","year":"2010"},{"key":"b13-0350002","series-title":"Plast Reconstr Surg","first-page":"492","article-title":"What is the optimal time to start helmet therapy in positional plagiocephaly?","volume":"128","author":"Kluba","year":"2011"},{"key":"b14-0350002","series-title":"J Craniofac Surg","first-page":"1301","article-title":"Does helmet therapy influence the ear shift in positional plagiocephaly?","volume":"23","author":"Kluba","year":"2012"},{"key":"b15-0350002","series-title":"Cleft Palate Craniofac J","first-page":"240","article-title":"Long-term treatment effectiveness of molding helmet therapy in the correction of posterior deformational plagiocephaly: a five-year follow-up","volume":"45","author":"Lee","year":"2008"},{"key":"b16-0350002","series-title":"J Craniofac Surg","first-page":"139","article-title":"A pneumatic orthotic cranial molding helmet for correcting positional plagiocephaly","volume":"17","author":"Lee","year":"2006"},{"key":"b17-0350002","series-title":"Pediatrics","first-page":"e936","article-title":"Helmet versus active repositioning for plagiocephaly: a three-dimensional analysis","volume":"126","author":"Lipira","year":"2010"},{"key":"b18-0350002","series-title":"J Neurosurg Pediatr","first-page":"219","article-title":"Deformational plagiocephaly","volume":"2","author":"Littlefield","year":"2010"},{"issue":"4S","key":"b19-0350002","series-title":"J Prosthet Orthot","first-page":"35","article-title":"FDA regulation of cranial remodeling devices","volume":"16","author":"Littlefield","year":"2004"},{"issue":"3","key":"b20-0350002","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Dynamic orthotic cranioplasty: treatment of the older infant. Report of four cases","volume":"9","author":"Littlefield","year":"2000"},{"key":"b21-0350002","series-title":"Semin Pediatr Neurol","first-page":"301","article-title":"On the current incidence of deformational plagiocephaly: an estimation based on prospective registration at a single center","volume":"11","author":"Littlefield","year":"2004"},{"key":"b22-0350002","series-title":"J Pediatr Health Care","first-page":"242","article-title":"Evidence-based care of the child with deformational plagiocephaly, Part I: assessment and diagnosis","volume":"26","author":"Looman","year":"2012"},{"key":"b23-0350002","series-title":"Plast Reconstr Surg","first-page":"1866","article-title":"Nonsynostotic occipital plagiocephaly: factors impacting onset, treatment, and outcomes","volume":"119","author":"Losee","year":"2007"},{"key":"b24-0350002","series-title":"Dev Med Child Neurol","first-page":"568","article-title":"Head shape measurement standards and cranial orthoses in the treatment of infants with deformational plagiocephaly","volume":"50","author":"McGarry","year":"2008"},{"key":"b25-0350002","series-title":"J Orofac Orthop","first-page":"151","article-title":"Head orthesis therapy in infants with unilateral positional plagiocephaly: an interdisciplinary approach to broadening the range of orthodontic treatment","volume":"73","author":"Meyer-Marcotty","year":"2012"},{"key":"b26-0350002","series-title":"Childs Nerv Syst","first-page":"1407","article-title":"Deformational plagiocephaly and orthotic treatment: indications and limitations","volume":"28","author":"Mortenson","year":"2012"},{"key":"b27-0350002","series-title":"J Neurosurg","first-page":"667","article-title":"Nonsurgical, nonorthotic treatment of occipital plagiocephaly: what is the natural history of the misshapen neonatal head?","volume":"87","author":"Moss","year":"1997"},{"key":"b28-0350002","series-title":"Plast Reconstr Surg","first-page":"371","article-title":"Analysis of posterior plagiocephaly: deformational versus synostotic","volume":"103","author":"Mulliken","year":"1999"},{"key":"b29-0350002","series-title":"Clin Pediatr (Phila)","first-page":"292","article-title":"The infant with a misshapen head","volume":"46","author":"Nield","year":"2007"},{"key":"b30-0350002","series-title":"Community Pract","first-page":"38","article-title":"Plagiocephaly and awareness, prevention and treatment","volume":"81","author":"Otway","year":"2008"},{"key":"b31-0350002","series-title":"J Craniofac Surg","first-page":"1084","article-title":"Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer","volume":"17","author":"Plank","year":"2006"},{"key":"b32-0350002","series-title":"J Neurosurg Pediatr","first-page":"284","article-title":"Diagnosis and management of deformational plagiocephaly. A review","volume":"3","author":"Robinson","year":"2009"},{"key":"b33-0350002","series-title":"Plast Reconstr Surg","first-page":"941","article-title":"Comparison of a modifiable cranial cup versus repositioning and cervical stretching for the early correction of deformational posterior plagiocephaly","volume":"121","author":"Rogers","year":"2008"},{"key":"b34-0350002","series-title":"Arch Dis Child","first-page":"82","article-title":"Management of positional plagiocephaly","volume":"93","author":"Saeed","year":"2008"},{"key":"b35-0350002","series-title":"J Craniofac Surg","first-page":"1677","article-title":"Three-dimensional photographic analysis of outcome after helmet treatment of a nonsynostotic cranial deformity","volume":"21","author":"Schaaf","year":"2010"},{"key":"b36-0350002","series-title":"Plast Reconstr Surg","first-page":"55e","article-title":"Helmet treatment of deformational plagiocephaly: the relationship between age at initiation and rate of correction","volume":"131","author":"Seruya","year":"2013"},{"key":"b37-0350002","series-title":"Clin Invest Med","first-page":"E266","article-title":"Cosmetic and cognitive outcomes of positional plagiocephaly treatment","volume":"35","author":"Shamji","year":"2012"},{"key":"b38-0350002","series-title":"Arch Dis Child","first-page":"807","article-title":"What is the role of helmet therapy in positional plagiocephaly?","volume":"93","author":"Singh","year":"2008"},{"key":"b39-0350002","series-title":"Childs Nerv Syst","first-page":"1275","article-title":"Longterm outcome of infants with positional occipital plagiocephaly","volume":"23","author":"Steinbok","year":"2007"},{"key":"b40-0350002","series-title":"J Craniofac Surg","first-page":"399","article-title":"Deformational plagiocephaly associated with ocular torticollis: a clinical study and literature review","volume":"18","author":"Stevens","year":"2007"},{"key":"b41-0350002","series-title":"J Craniofac Surg","first-page":"362","article-title":"Outcome analysis of helmet therapy for positional plagiocephaly using a three-dimensional surface scanning laser","volume":"20","author":"Thompson","year":"2009"},{"key":"b42-0350002","series-title":"Pediatr Rehabil","first-page":"40","article-title":"Torticollis and plagiocephaly in infancy: therapeutic strategies","volume":"9","author":"van Vlimmeren","year":"2006"},{"key":"b43-0350002","series-title":"Trials","first-page":"108","article-title":"HElmet therapy Assessment in infants with Deformed Skulls (HEADS): protocol for a randomised controlled trial","volume":"13","author":"van Wijk","year":"2012"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/35\/4\/article-pE2.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/35\/4\/article-pE2.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/35\/4\/article-pE2.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:21:32Z","timestamp":1780734092000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/35\/4\/article-pE2.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10]]},"references-count":86,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2013.7.focus13260","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10]]}}}