{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:27:19Z","timestamp":1791502039159,"version":"4.3.4"},"reference-count":60,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Objective: The objective of this study is to analyze conservative treatments implemented to manage positional plagiocephaly in infants. Methods: This is a systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, performed in the Medline (PubMed), Scopus, Web of Science, and Cochrane databases. Articles were selected according to the eligibility criteria, regarding the effectiveness of conservative treatments in positional plagiocephaly in infants, published in the last 10 years with a score \u22653 in the PEDro Scale. Results: A total of 318 articles were identified and 9 of them were finally selected. Conclusions: Physical therapy treatment is considered as the first line of intervention in plagiocephaly with non-synostotic asymmetries and manual therapy is the method that obtains the best results within this intervention. In cases of moderate or severe plagiocephaly, helmet therapy can be an effective second-line intervention; however, the best way to prevent this condition is through counseling of parents or caregivers, and early treatment is essential for optimal therapeutic outcomes. The review was registered in PROSPERO (CDR42022306466).<\/jats:p>","DOI":"10.3390\/children10071184","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:35:21Z","timestamp":1688949321000},"page":"1184","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Effectiveness of Conservative Treatments in Positional Plagiocephaly in Infants: A Systematic Review"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5524-1587","authenticated-orcid":false,"given":"Maria","family":"Blanco-Diaz","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain"},{"name":"Physical Therapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4321-1440","authenticated-orcid":false,"given":"Maria","family":"Marcos-Alvarez","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8523-767X","authenticated-orcid":false,"given":"Isabel","family":"Escobio-Prieto","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Nursing, Physical Therapy and Podiatry, University of Seville, 41009 Seville, Spain"},{"name":"Institute of Biomedicine of Seville (IBIS), 41013 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8988-3708","authenticated-orcid":false,"given":"Marta","family":"De la Fuente-Costa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain"},{"name":"Physical Therapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3466-6500","authenticated-orcid":false,"given":"Borja","family":"Perez-Dominguez","sequence":"additional","affiliation":[{"name":"Exercise Intervention for Health Research Group (EXINH-RG), Department of Physical Therapy, University of Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9611-3939","authenticated-orcid":false,"given":"Elena","family":"Pinero-Pinto","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Nursing, Physical Therapy and Podiatry, University of Seville, 41009 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4994-5825","authenticated-orcid":false,"given":"Alvaro Manuel","family":"Rodriguez-Rodriguez","sequence":"additional","affiliation":[{"name":"Physical Therapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.3928\/19382359-20221114-03","article-title":"Positional Plagiocephaly and Craniosynostosis","volume":"52","author":"Santiago","year":"2023","journal-title":"Pediatr. Ann."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"86e","DOI":"10.1097\/PRS.0b013e318272c12b","article-title":"Craniofacial syndromes, and surgery","volume":"131","author":"Forrest","year":"2013","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/00001665-199601000-00005","article-title":"An increase in infant cranial deformity with supine sleeping position","volume":"7","author":"Argenta","year":"1996","journal-title":"J. Craniofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.7181\/acfs.2020.00059","article-title":"Diagnosis and treatment of positional plagiocephaly","volume":"21","author":"Jung","year":"2020","journal-title":"Arch. Craniofac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1542\/peds.2012-3438","article-title":"The incidence of positional plagiocephaly: A cohort study","volume":"132","author":"Mawji","year":"2013","journal-title":"Pediatrics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1097\/SCS.0000000000004809","article-title":"Early surgical treatment in anterior synostotic plagiocephaly: Is this the best choice?","volume":"29","author":"Gasparini","year":"2018","journal-title":"J. Craniofac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.pedhc.2011.10.003","article-title":"Evidence-based care of child with deformational Plagiocephaly, part I: Assessment and diagnosis","volume":"26","author":"Looman","year":"2012","journal-title":"J. Pediatr. Health Care"},{"key":"ref_8","first-page":"85","article-title":"Risk factors associated with positional plagiocephaly in healthy Iranian infants: A case-control study. Iran","volume":"16","author":"Solani","year":"2022","journal-title":"J. Child. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1093\/pch\/19.8.423","article-title":"Risk factors for positional plagiocephaly and appropriate time frames for prevention messaging","volume":"19","author":"Mawji","year":"2014","journal-title":"Paediatr. Child. Health"},{"key":"ref_10","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":"Braun","year":"2017","journal-title":"Arch. Dis. Child."},{"key":"ref_11","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":"Laughlin","year":"2011","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1007\/s00381-012-1731-y","article-title":"Brain volume and shape in infants with deformational plagiocephaly","volume":"28","author":"Collett","year":"2012","journal-title":"Childs. Nerv. Syst."},{"key":"ref_13","first-page":"182","article-title":"Plagiocefalia posicional: Enfermedad o anomal\u00eda est\u00e9tica","volume":"37","author":"Zamorano","year":"2013","journal-title":"Canar. Pedi\u00e1tr."},{"key":"ref_14","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":"Bialocerkowski","year":"2008","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1808","DOI":"10.1097\/SCS.0000000000001948","article-title":"Assessment of head shape by craniofacial teams: Structuring practice parameters to optimize efficiency","volume":"26","author":"Purnell","year":"2015","journal-title":"J. Craniofac. Surg."},{"key":"ref_16","first-page":"59","article-title":"Deformational Plagiocephaly: A Review","volume":"43","author":"Ditthakasem","year":"2017","journal-title":"Pediatr. Nurs."},{"key":"ref_17","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\u201312 weeks of life","volume":"177","author":"Ballardini","year":"2018","journal-title":"Eur. J. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1097\/SCS.0000000000002016","article-title":"Guideline for care of patients with the diagnoses of craniosynostosis: Working group on craniosynostosis","volume":"26","author":"Mathijssen","year":"2015","journal-title":"J. Craniofac. Surg."},{"key":"ref_19","first-page":"136","article-title":"Positional plagiocephaly: Pathogenesis, diagnosis, and management","volume":"104","author":"Morrison","year":"2006","journal-title":"J. Kentucky Med. Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Santos, J., Gonz\u00e1lez-Bernal, J.J., De-la-Fuente Anuncibay, R., Soto-C\u00e1mara, R., Cubo, E., and Aguilar-Parra, J.M.J.M. (2020). Infant Cranial Deformity: Cranial Helmet Therapy or Physiotherapy?. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17072612"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s13052-021-01079-4","article-title":"Efficacy of pediatric integrative manual therapy in positional plagiocephaly: A randomized controlled trial","volume":"47","year":"2021","journal-title":"Ital. J. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., and Brennan, S.E. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. PLoS Med., 18.","DOI":"10.1371\/journal.pmed.1003583"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1053\/apnr.2002.34181","article-title":"Popping the (PICO) question in research and evidence-based practice","volume":"15","author":"Stone","year":"2002","journal-title":"Appl. Nurs. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13052-021-00995-9","article-title":"Effectiveness of pediatric integrative manual therapy in cervical movement limitation in infants with positional plagiocephaly: A randomized controlled trial","volume":"47","year":"2021","journal-title":"Ital. J. Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1093\/ejo\/cjy012","article-title":"Head orthosis therapy in positional plagiocephaly: Longitudinal 3D-investigation of long-term outcomes, compared with untreated infants and with a control group","volume":"41","author":"Kunz","year":"2019","journal-title":"Eur. J. Orthod."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1097\/PRS.0000000000000955","article-title":"Effectiveness of conservative therapy and helmet therapy for positional cranial deformation","volume":"135","author":"Steinberg","year":"2015","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1097\/SCS.0000000000005665","article-title":"Treatment of Deformational Plagiocephaly with Physiotherapy","volume":"30","author":"Ramieri","year":"2019","journal-title":"J. Craniofac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1097\/SCS.0000000000001511","article-title":"Argenta clinical classification of deformational plagiocephaly","volume":"26","author":"Branch","year":"2015","journal-title":"J. Craniofac. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.1469-8749.1998.tb15399.x","article-title":"Assessment of gross motor skills of at-risk infants: Predictive validity of the Alberta Infant Motor Scale","volume":"40","author":"Darrah","year":"1998","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1093\/ptj\/83.8.713","article-title":"Reliability of the PEDro Scale for Rating Quality of Randomized Controlled Trials","volume":"83","author":"Maher","year":"2003","journal-title":"Phys. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/S0895-4356(00)00360-7","article-title":"The art of quality assessment of RCTs included in systematic reviews","volume":"54","author":"Verhagen","year":"2001","journal-title":"J. Clin. Epidemiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"304","DOI":"10.20453\/reh.v25i4.2740","article-title":"An\u00e1lisis cr\u00edtico de ensayos cl\u00ednicos aleatorizados: Riesgo de sesgo","volume":"25","year":"2016","journal-title":"Rev. Estomatol\u00f3gica Hered."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1097\/PRS.0b013e3182729f11","article-title":"Helmet treatment of deformational plagiocephaly: The relationship between age at initiation and rate of correction","volume":"131","author":"Seruya","year":"2013","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_35","first-page":"2211","article-title":"Effects of manual therapy on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly: A randomised controlled pilot study","volume":"32","author":"Valenza","year":"2015","journal-title":"Childs Nerv. Syst."},{"key":"ref_36","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":"Ijzerman","year":"2014","journal-title":"BMJ"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"273","DOI":"10.3171\/2016.9.PEDS16275","article-title":"Factors influencing outcomes of the treatment of positional plagiocephaly in infants: A 7-year experience","volume":"19","author":"Lam","year":"2017","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.nurpra.2016.10.015","article-title":"Deformational Plagiocephaly\u2014A Focus on Prevention","volume":"13","author":"Unwin","year":"2017","journal-title":"J. Nurse Pract."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.jpeds.2008.10.027","article-title":"Physical therapy is effective for deformational plagiocephaly","volume":"154","author":"Robbins","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1080\/13638490500037904","article-title":"Torticollis and plagiocephaly in infancy: Therapeutic strategies","volume":"9","author":"Helders","year":"2006","journal-title":"Pediatr. Rehabil."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"E632","DOI":"10.1227\/NEU.0000000000001430","article-title":"Guidelines: 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":"Tamber","year":"2016","journal-title":"Neurosurgery"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ijom.2020.06.020","article-title":"Evaluation of positional cranial deformities: The non-expert perspective","volume":"50","author":"Naros","year":"2021","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_43","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":"Baird","year":"2016","journal-title":"Neurosurgery"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.jcms.2022.05.001","article-title":"Helmet therapy for positional cranial deformations; a 5-year follow-up study","volume":"50","author":"Feijen","year":"2022","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"294","DOI":"10.23736\/S2724-5276.17.04838-1","article-title":"The functional manual therapy intervention in infants with non-synostotic plagiocephaly: A pilot study","volume":"74","author":"Billi","year":"2022","journal-title":"Minerva Pediatr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1097\/PRS.0b013e31821b62d6","article-title":"What is the optimal time to start helmet therapy in positional plagiocephaly?","volume":"128","author":"Kluba","year":"2011","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3171\/2009.1.PEDS08330","article-title":"Diagnosis, and management of deformational plagiocephaly","volume":"3","author":"Robinson","year":"2009","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1097\/SCS.0b013e31815c8a27","article-title":"Molding therapy of positional plagiocephaly: Subjective outcome and quality of life","volume":"19","author":"Govaert","year":"2008","journal-title":"J. Craniofac. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/SCS.0000000000002167","article-title":"Treated Versus Untreated Positional Head Deformity","volume":"27","author":"Wilbrand","year":"2016","journal-title":"J. Craniofac. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s00381-019-04215-y","article-title":"A new parameter for the management of positional plagiocephaly: The size of the anterior fontanelle matters","volume":"36","author":"Lochbihler","year":"2020","journal-title":"Childs. Nerv. Syst."},{"key":"ref_51","first-page":"198","article-title":"Management of positional head deformity in 31 infants","volume":"19","author":"Pan","year":"2017","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2736","DOI":"10.1097\/SCS.0000000000007811","article-title":"Demographics of Positional Plagiocephaly and Brachycephaly; Risk Factors and Treatment","volume":"32","author":"Feijen","year":"2021","journal-title":"J. Craniofac. Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e295","DOI":"10.3346\/jkms.2020.35.e295","article-title":"Applicative Factors of Helmet Molding Therapy in Late-diagnosed Positional Plagiocephaly","volume":"35","author":"Kim","year":"2020","journal-title":"J. Korean Med. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1111\/jpc.14717","article-title":"Effect of helmet therapy in the treatment of positional head deformity","volume":"56","author":"Wen","year":"2020","journal-title":"J. Paediatr. Child. Health"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1097\/PRS.0b013e31818cc388","article-title":"Unoperated craniosynostosis patients: Correction in adulthood","volume":"122","author":"Marchac","year":"2008","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e440","DOI":"10.3928\/19382359-20200922-02","article-title":"Safe Sleep, Plagiocephaly, and Brachycephaly: Assessment, Risks, Treatment, and When to Refer","volume":"49","author":"Marshall","year":"2020","journal-title":"Pediatr. Ann."},{"key":"ref_57","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":"Pawelczak","year":"2022","journal-title":"J. Neurosurg. Sci."},{"key":"ref_58","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":"Engelbert","year":"2017","journal-title":"Eur. J. Pediatr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.2522\/ptj.20130304","article-title":"Response to pediatric physical therapy in infants with positional preference and skull deformation","volume":"94","author":"Pelsma","year":"2014","journal-title":"Phys. Ther."},{"key":"ref_60","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":"Ellwood","year":"2020","journal-title":"Chiropr. Man. 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