Research into helmet therapy in the UK is still limited. Plagiocephaly is not always managed in the same way across services, and head shape measurements are not routinely recorded during infancy. Because of this, much of the published research comes from outside the UK.
Even so, the available evidence can still help parents and clinicians understand when repositioning may be enough and when helmet therapy may be worth considering.
If you are looking for a general overview first, you can read more about plagiocephaly or explore plagiocephaly treatment.
Conservative treatment compared with helmet therapy
Study: Conducted at Children’s Memorial Hospital, Chicago (2004-2011), analysing 4,378 babies.
Published: Journal of Plastic & Reconstructive Surgery (March 2015).
This study compared conservative treatment, such as repositioning and physiotherapy, with helmet therapy.
Results:
- Conservative treatment (repositioning and physiotherapy):
- 77.1% achieved complete correction.
- 15.8% needed to transition to helmet therapy.
- 7.1% had incomplete correction.
- Helmet therapy (first-line treatment):
- 94.4% achieved complete correction.
- 96.1% of babies who failed conservative therapy later achieved full correction with helmets.
The babies in the helmet group were generally older and had more severe head asymmetry than those in the repositioning group.
Risk factors for treatment failure:
- Conservative treatment:
- poor compliance
- older age
- prolonged torticollis
- more severe cranial ratio
- developmental delay
- Helmet therapy failure risks:
This study suggests that helmet therapy may be particularly helpful for babies with more noticeable plagiocephaly or brachycephaly, while repositioning may be more helpful for younger babies with milder head shape differences. Treatment decisions should always be based on the individual baby’s presentation and clinical history.
View research paper here
Helmet therapy compared with no helmet therapy
This study compared babies treated with a helmet with babies who did not receive helmet treatment.
Study details
- 128 infants enrolled (62 with helmet therapy, 66 without).
Reported results:
-
- babies treated with a helmet showed 68% improvement
- babies without helmet showed 31% improvement
- babies with more severe asymmetry appeared to benefit most from helmet therapy
These findings add to the wider evidence suggesting that helmet therapy may be helpful for some babies, particularly where asymmetry is more pronounced. Outcomes can vary depending on age, severity and time in treatment.
View research paper here