Conservative and Helmet Therapy - Positional Cranial Deformation
Home News 2015 April 09 Effectiveness of Conservative Therapy and Helmet Therapy For Positional Cranial Deformation

Conservative and Helmet Therapy - Positional Cranial Deformation


This is a retrospective study of the effectiveness of treatment for 4,378 babies between 2004 and 2011 at the Children's Memorial Hospital, Chicago, Illinois.It compares conservative treatment (repositioning with or without physiotherapy) and helmet therapy for plagiocephaly and brachycephaly

The research paper was published in March 2015 in the Journal of Plastic & Reconstructive Surgery.



Complete correction was achieved in 77.1% of conservative treatment patients, 15.8% required transition to helmet therapy and 7.1% ultimately had incomplete correction.

For babies who received helmet therapy as first line therapy complete correction was achieved in 94.4% of cases and in 96.1% of infants that received helmet therapy after the failure of conservative therapy.

The babies in the helmet group on average started with more severe head and neck deformity, and were older than the babies in the conservatively treated group.

LOC Comments

This is the biggest research sample to date. The initial treatment regime was jointly agreed by health professionals and parents. The authors have identified risk factors for failure of conservative treatment:

  • Poor compliance
  • Advanced age of baby
  • Prolonged torticollis
  • Severity of the initial cranial ratio
  • Developmental delay

Risk factors for failure of helmet treatment were:

  • Poor compliance
  • Advanced age of baby

This study confirms our clinician's view that helmet therapy is the correct treatment for babies with moderate to severe plagiocephaly or brachycephaly but repositioning does work for young babies with mild cranial deformation. A full abstract of the research paper can be downloaded for free.

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