{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:23:49Z","timestamp":1789190629383,"version":"build-2803163510"},"reference-count":39,"publisher":"Korean Pediatric Society","issue":"11","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-cep.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Pediatr"],"published-print":{"date-parts":[[2025,11,15]]},"abstract":"<jats:p>Background: Positional plagiocephaly (PP) is a common cranial asymmetry of infancy. Its treatment options include conservative management and helmet therapy. However, the efficacy of each, particularly at achieving a normal cranial shape, remains uncertain.Purpose: This study aimed to compare the efficacy of conservative management and helmet therapy for PP.Methods: We retrospectively analyzed 199 infants with PP treated in 2015\u20132024. A total of 72 patients with a minimum treatment duration of 90 days and minimum plagiocephaly severity level of 2 (Children's Healthcare Atlanta Plagiocephaly Severity Scale) were included. Of them, 36 received conservative management and 36 received helmet therapy. Each infant underwent three-dimensional surface scanning of the cranium (StarScanner).Results: The mean\u00b1standard deviation age at treatment initiation was 31.9\u00b16.6 weeks in the helmet group versus 21.0\u00b15.7 weeks in the conservative management group (P&lt;0.001). The average treatment duration was 21.9 (interquartile range [IQR], 15.3\u201331.4) weeks vs. 20.6 (IQR, 14.1\u201326.6) weeks (P=0.171), respectively. The monthly correction speed of the cranial vault asymmetry index (CVAI) was comparable between groups (0.66\u00b12.09 vs. 0.64\u00b10.55, P=0.964). Plagiocephaly degree was reduced to level 1 in 9 of 36 patients (25%) who received helmet therapy versus 4 of 36 patients (11%) in the conservative management group (P=0.220), whereas a reduction in severity level was observed in 24 of 36 (67%) versus 15 of 36 (42%), respectively (P=0.058). In the helmet group, an earlier treatment initiation was significantly associated with a greater severity level reduction (r=-0.480, P=0.003). A longer treatment duration showed a trend toward a greater reduction in CVAI (r=0.331, P=0.052). In the conservative management group, both earlier treatment initiation (r=-0.537, P&lt;0.001) and longer treatment duration (r=0.381, P=0.022) correlated significantly with improved outcomes.Conclusion: Conservative management and helmet therapy reduced cranial asymmetry with no significant difference in correction speed. An early treatment initiation was the strongest predictor of improvement, while a longer treatment duration was associated with better outcomes. A trend toward a greater reduction in severity level was observed with helmet therapy, suggesting its potential benefits in more severe cases.<\/jats:p>","DOI":"10.3345\/cep.2025.01102","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T05:10:46Z","timestamp":1759381846000},"page":"892-900","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative analysis of goal attainment for helmet therapy versus conservative management for positional plagiocephaly in infants"],"prefix":"10.3345","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8781-2751","authenticated-orcid":true,"given":"Bjoern","family":"Vogt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1089-9972","authenticated-orcid":true,"given":"Ariane","family":"Deutschle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Gosheger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1043-5895","authenticated-orcid":true,"given":"Adrien","family":"Frommer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-2298","authenticated-orcid":true,"given":"Andrea","family":"Laufer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Tretow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1731-6293","authenticated-orcid":true,"given":"Robert","family":"Roedl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8428-6031","authenticated-orcid":true,"given":"Gregor","family":"Toporowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1897","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.7181\/acfs.2020.00059"},{"key":"ref2","first-page":"136","volume-title":"Positional 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