Use of orthotic helmets in children with positional plagiocephaly and brachycephaly: a systematic review.

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Child's Nervous System Pub Date : 2025-04-22 DOI:10.1007/s00381-025-06826-0

Amauri Dalla Corte, Marcelo Anchieta Rohde

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引用次数: 0

Abstract

Purpose: This review aims to evaluate the scientific evidence on the efficacy and safety of cranial orthotic therapy (helmet therapy) in children under 12 months with moderate to severe posicional plagiocephaly and brachycephaly.

Methods: A systematic review was performed in PubMed, EMBASE, and Cochrane databases. Additional searches were conducted in regulatory agency repositories for relevant notifications.

Results: A total of 19 studies were included in the review, assessing various treatment modalities for PP. Repositioning therapy demonstrated effectiveness in reducing cranial asymmetry for mild to moderate cases, but several studies (class I and II evidence) indicated that it was less effective than both physical therapy and helmet use. Physical therapy, particularly manual therapy combined with caregiver counseling, showed superior outcomes for non-synostotic cranial asymmetry. Helmet therapy was consistently recommended for infants with moderate to severe deformities, with better outcomes when initiated during early infancy.

Conclusion: Helmet therapy is safe and effective for specific cases, especially moderate to severe PP or brachycephaly, with improved results when started early. However, available studies have methodological limitations, and the decision to use helmet therapy should be individualized, considering the severity of the deformity, patient age, and response to other treatments.

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矫正头盔在位置性斜头畸形和短头畸形儿童中的应用：一项系统综述。

目的：本综述旨在评价颅内矫形治疗（头盔治疗）治疗12个月以下中重度斜头畸形和短头畸形的有效性和安全性的科学证据。方法：在PubMed、EMBASE和Cochrane数据库中进行系统评价。在监管机构知识库中进行了相关通知的额外搜索。结果：本综述共纳入了19项研究，评估了PP的各种治疗方式。重新定位治疗在减少轻度至中度病例的颅骨不对称方面显示出有效性，但一些研究（I类和II类证据）表明其效果不如物理治疗和头盔使用。物理治疗，特别是手工治疗结合照顾者咨询，显示出非吻合性颅不对称的优越结果。头盔治疗一直被推荐用于中度至重度畸形的婴儿，在婴儿早期开始治疗效果更好。结论：头盔治疗对特定病例安全有效，尤其是中重度PP或短头畸形，早期开始治疗效果更好。然而，现有的研究有方法学上的局限性，使用头盔治疗的决定应个体化，考虑到畸形的严重程度、患者的年龄和对其他治疗的反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child's Nervous System 医学-临床神经学

CiteScore

3.00

自引率

7.10%

发文量

322

审稿时长

3 months

期刊介绍： The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.