What effect does a paediatric physiotherapist-led parent education programme have on the Incidence and Severity of Positional Plagiocephaly in babies at two months of age, compared to standard care?

Introduction Positional plagiocephaly (PP) is a deformational skull deformity that affects otherwise healthy infants in the first six months of life. Parent education programmes are advocated in the literature for the... [ view full abstract ]

Introduction

Positional plagiocephaly (PP) is a deformational skull deformity that affects otherwise healthy infants in the first six months of life. Parent education programmes are advocated in the literature for the prevention of PP. Paediatric physiotherapists who treat infants with PP as part of their normal clinical caseload have valuable experience in the area of PP but usually have no role in delivering PP prevention programmes for parents.

Objectives

The main objective of the study was to investigate the effects of a group based parent education session, delivered by a paediatric physiotherapist on the Maternity ward on the day of discharge, on the incidence and severity of PP in babies at two months of age, compared to normal care.

Methodology

A prospective, non-randomised, controlled, experimental study was carried out on the maternity unit of an Irish regional teaching hospital. Mothers in the control group received PP prevention advice as part of their standard care from a midwife or women’s health physiotherapist. Mothers in the intervention group also received standard care but participated in an additional group education session delivered by a paediatric physiotherapist prior to discharge.

Results

A total of 114 mothers and 115 babies participated in the study. At the two month follow-up assessment the incidence of PP in the intervention group was 26% compared to 54% in the control group (difference -28%, (95% CI (-43.6 to -10.2), p= 0.002). Mothers in the intervention group were more likely to adhere to information regarding PP prevention strategies in the domains of infant head turning (p= 0.0002), environmental adaptations of nursery equipment (p= 0.0002), frequent lifting for feeding (p= 0.02) and were more satisfied with the information they received compared to mothers in the control group (p= 0.007).

Conclusions

A paediatric physiotherapist-led parent education session, that promoted awareness of and adherence to PP prevention strategies during early infant care-giving activities, significantly reduced the incidence of PP at two months of age and increased maternal satisfaction with the advice they had received.

Ethics 

Ethical approval was granted by the Research Ethics Committee of Sligo University Hospital, Great Ormond Street Hospital and University College London.