{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:24:34Z","timestamp":1789075474488,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Helmet therapy is considered to be a treatment for infants with positional plagiocephaly. Although some studies suggest that anterior fontanelle (AF) size may also affect treatment outcomes, evidence and influence remain unclear. The aim of this study is to assess the impact of anterior fontanelle size on the effectiveness of helmet therapy, with the goal of determining the optimal timing and patient criteria for treatment. Methods: We conducted a retrospective study of 94 infants treated with helmet therapy for positional plagiocephaly at Kwangju Christian Hospital between January 2020 and December 2021. Patients were divided into two age groups (\u22646 months and &gt;6 months) and three SAF quartiles (\u226425%, 25\u201375%, \u226575%). Parameters reflecting the degree of cranial asymmetry correction, including cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI), were recorded at the start and end of treatment. Results: Infants aged \u22646 months showed significantly greater improvements in cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI) compared to older infants (CVA: 4.57 \u00b1 2.30 mm vs. 7.04 \u00b1 3.85 mm, p = 0.003; CVAI: 3.10 \u00b1 1.55% vs. 4.45 \u00b1 2.44%, p = 0.011). When analyzed by anterior fontanelle (AF) size quartiles (\u226425%, 25\u201375%, \u226575%), no significant differences in treatment outcomes were observed at the end of therapy for CVA (p = 0.88) or CVAI (p = 0.91). In infants \u22646 months, SAF quartile analysis also showed no significant differences in CVA (p = 0.97) or CVAI (p = 0.98) improvements. Conclusions: Our findings indicate that anterior fontanelle size is not a predictor of helmet therapy outcomes in positional plagiocephaly. Early initiation of helmet therapy (\u22646 months) remains the most critical factor for achieving optimal results.<\/jats:p>","DOI":"10.3390\/jcm15020566","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:20:37Z","timestamp":1768206037000},"page":"566","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors Associated with Helmet Therapy Outcomes in Positional Plagiocephaly"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2658-3606","authenticated-orcid":false,"given":"Sumin","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunju","family":"Na","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Won","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Ok","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6805-5727","authenticated-orcid":false,"given":"Eunyoung","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Hyuk","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunghoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihong","family":"Cheon","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3769-6227","authenticated-orcid":false,"given":"Hyeng-Kyu","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Research Institute of Medical Sciences, Heart Research Center, Chonnam National University Medical School & Hospital, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4906-6089","authenticated-orcid":false,"given":"Younkyung","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Gwangju Christian Hospital, Gwangju 61661, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"ref_1","first-page":"136","article-title":"Positional Plagiocephaly: Pathogenesis, Diagnosis, and Management","volume":"104","author":"Morrison","year":"2006","journal-title":"J. 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