Physiotherapy Educational Intervention for Occipital Positional Plagiocephaly Prevention: a Multicentre Randomised Controlled Trial
- 1Department of Health Professions, Azienda USL Toscana Centro, 51100, Pistoia, Italy
Abstract
QuestionsWhat is the effectiveness of a prenatal educational physiotherapy intervention in reducing the prevalence of positional occipital plagiocephaly (POP) and POP-associated disorders in infants at 3 months of age?
DesignTwo-arm assessor-blind multicentre, randomised controlled trial.
Participants400 pregnant women
InterventionThe experimental group received specific physiotherapy educational session on POP prevention strategies during the regular antenatal education class meeting. The oblique diameter difference index (ODDI) is the primary outcome. Secondary outcomes included musculoskeletal POP-associated conditions.
ResultsThree hundred twenty-eight newborns completed the study. The ODDI scores showed no statistically significant difference between the groups at 3 months (mean difference -0.28 [95% CI: -0.72 to 0.17; p = 0.218]). The prevalence of POP did not differ between the two groups (21.1% in the intervention group, 22.2% in the control group), which is lower than data reported in the literature (37.8%-46.6%). No statistically significant between-group differences were found in secondary outcomes, except for spinal postural asymmetry (aRR = 0.95; 95% CI: 0.90 to 0.99; p = 0.031). There were no significant differences in the caregiving strategies adopted during the first three months of life.
ConclusionA low POP prevalence was observed, with no statistically significant differences between groups, as both groups adopted preventive strategies. The lack of superiority of the structured education may suggest a shift in parental education. With more health information on social media and the global ease of sharing, parents have relied on digital self-treatment, reducing the interventions impact; thus, the face-to-face model for low-risk infants may be outdated.
Registration numberNCT07182604 (retrospective). The protocol was prospectively registered at the Meyer Childrens Hospital IRCCS (January 20, 2020).
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BibTeX
@misc{fortini2026physiotherapy,
title = {{Physiotherapy Educational Intervention for Occipital Positional Plagiocephaly Prevention: a Multicentre Randomised Controlled Trial}},
author = {V. Fortini and F. Picone and S. Giustini and P. Fanzaghi and M. Santoni and M. Calistri and R. Guarise and N. Ferri},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.03.26362040},
url = {https://www.medrxiv.org/content/10.64898/2026.09.03.26362040v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Physiotherapy Educational Intervention for Occipital Positional Plagiocephaly Prevention: a Multicentre Randomised Controlled Trial
AU - V. Fortini
AU - F. Picone
AU - S. Giustini
AU - P. Fanzaghi
AU - M. Santoni
AU - M. Calistri
AU - R. Guarise
AU - N. Ferri
PY - 2026
DA - 2026/09/03
PB - medRxiv
DO - 10.64898/2026.09.03.26362040
UR - https://www.medrxiv.org/content/10.64898/2026.09.03.26362040v1
AB - QuestionsWhat is the effectiveness of a prenatal educational physiotherapy intervention in reducing the prevalence of positional occipital plagiocephaly (POP) and POP-associated disorders in infants at 3 months of age? DesignTwo-arm assessor-blind multicentre, randomised controlled trial. Participants400 pregnant women InterventionThe experimental group received specific physiotherapy educational session on POP prevention strategies during the regular antenatal education class meeting. The oblique diameter difference index (ODDI) is the primary outcome. Secondary outcomes included musculoskeletal POP-associated conditions. ResultsThree hundred twenty-eight newborns completed the study. The ODDI scores showed no statistically significant difference between the groups at 3 months (mean difference -0.28 [95% CI: -0.72 to 0.17; p = 0.218]). The prevalence of POP did not differ between the two groups (21.1% in the intervention group, 22.2% in the control group), which is lower than data reported in the literature (37.8%-46.6%). No statistically significant between-group differences were found in secondary outcomes, except for spinal postural asymmetry (aRR = 0.95; 95% CI: 0.90 to 0.99; p = 0.031). There were no significant differences in the caregiving strategies adopted during the first three months of life. ConclusionA low POP prevalence was observed, with no statistically significant differences between groups, as both groups adopted preventive strategies. The lack of superiority of the structured education may suggest a shift in parental education. With more health information on social media and the global ease of sharing, parents have relied on digital self-treatment, reducing the interventions impact; thus, the face-to-face model for low-risk infants may be outdated. Registration numberNCT07182604 (retrospective). The protocol was prospectively registered at the Meyer Childrens Hospital IRCCS (January 20, 2020).
ER -