The Effect of Pediatric Physiotherapy on Positional Plagiocephaly: A Retrospective Trial

Abstract

Objective Positional plagiocephaly represents one of the most common asymmetries in infancy with increasing incidence in the last three decades. Therapeutic options are numerous. Therefore the comparison of physiotherapeutic approaches according to Bobath concept versus Vojta principle for correction of positional plagiocephaly gives an inside view.

Material and Methods Cranial vault asymmetry index (CVAI) and ear shift at a mean age of 3/6/9 months of 189 infants with positional plagiocephaly were measured by three-dimensional scans. The effectiveness was determined and compared based on CVAI and ear shift. The correlation of severity was calculated.

Results The relative probability of success was 84% higher for Vojta compared to Bobath. Mean change of CVAI revealed a significantly greater reduction for infants treated with Vojta, as well as for ear shift. Improvement occurred especially from age of 6–9 months. Treatment duration was significantly shorter with Vojta and severe cases of positional plagiocephaly benefited significantly more.

Conclusion Comparing the effectiveness of both physiotherapeutic treatment concepts on a neurophysiological basis according to Bobath and Vojta the presented retrospective data analysis provides statistically superior results in reducing skull asymmetry more effectively and faster in favor to the Vojta principle. Physiotherapy should be applied independent from severity and is effective for children older than 5–6 months.

Zusammenfassung

Hintergrund Die lagebedingte Plagiozephalie stellt eine der häufigsten Asymmetrien im Säuglingsalter dar. Therapeutische Möglichkeiten sind zahlreich. Der Vergleich von krankengymnastischer Behandlung auf neurophysiologischer Basis nach dem Bobath-Konzept und dem Vojta-Prinzip bietet einen näheren Einblick.

Material und Methoden Cranial Vault Asymmetry Index (CVAI) und Ohrversatz (ear shift) wurden im durchschnittlichen Alter von 3/6/9 Monaten mit lasergestützten 3D-Scannern von 189 Säuglingen mit lagebedingter Plagiozephalie bestimmt. Die Wirksamkeit der Therapie wurde anhand der Parameter CVAI und Ohrversatz objektiviert und verglichen. Des Weiteren wurde eine Korrelation des Schweregrades auf den Therapieerfolg berechnet.

Ergebnisse Die relative Erfolgswahrscheinlichkeit war bei der Behandlung nach Vojta im Vergleich zu der nach Bobath um 84%-Punkte höher. Die mittlere Veränderung von CVAI und Ohrversatz zeigten bei den mit Vojta behandelten Säuglingen eine signifikant stärkere Reduktion der Schädelasymmetrie. Die Behandlungsdauer war in der Vojta-Gruppe signifikant kürzer und schwerer betroffene Säuglinge profitierten signifikant deutlicher.

Schlussfolgerung Bei dem Vergleich der beiden physiotherapeutischen Behandlungskonzepte auf neurophysiologischer Basis nach Bobath und Vojta liefert das Vojta-Prinzip in der vorgestellten retrospektiven Datenanalyse statistisch überlegene Ergebnisse mit einer effektiveren Symmetrieherstellung und einer schnelleren Reduktion der Schädelasymmetrie. Die vorliegenden Ergebnisse weisen darauf hin, dass Physiotherapie unabhängig vom Schweregrad der Schädelasymmetrie frühzeitig aufzunehmen ist, sowie auch und über den 5.-6. Lebensmonat hinaus Anwendung finden sollte.

Key words

therapeutics - infant development - rehabilitation

Schlüsselwörter

Therapie - kindliche Entwicklung - Rehabilitation

• Literatur

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