TY - JOUR
T1 - Response to Pediatric Physical Therapy in Infants With Positional Preference and Skull Deformation
AU - van Wijk, Renske
AU - Pelsma, Maaike
AU - Groothuis-Oudshoorn, Catharina Gerarda Maria
AU - IJzerman, Maarten Joost
AU - van Vlimmeren, Leo A.
AU - Boere-Boonekamp, Magdalena M.
PY - 2014/5/1
Y1 - 2014/5/1
N2 - Background Pediatric physical therapy (PPT) seems to reduce skull deformation in infants with positional preference. However, not all infants show improvement.
Objective The purpose of this study was to determine which infant and parent characteristics were related to response to PPT in 2-4 month-old infants with positional preference and/or skull deformation.
Design A prospective cohort study.
Methods Infants 2–4 months old with positional preference and/or skull deformation were recruited by pediatric physical therapists at the start of PPT. Primary outcome was good or poor response (moderate/severe skull deformation) at 4.5 to 6.5 months of age. Potential predictors for response to PPT were assessed at baseline using questionnaires, plagiocephalometry, and the Alberta Infant Motor Scale. Univariate and multiple logistic regression analyses using a stepwise backward elimination method were performed.
Results 657 infants participated in the study. At follow-up 364 infants (55.4%) showed poor response and 293 infants (44.6%) good response to therapy. Multiple logistic regression analysis resulted in the identification of four significant predictors at baseline for poor response to PPT: starting therapy after 3 months of age (adjusted odds ratio [aOR]: 1.50, 95% CI 1.04 to 2.17), skull deformation (plagiocephaly (aOR: 2.64, 1.67 to 4.17), brachycephaly (aOR: 3.07, 2.09 to 4.52)) and a low parental satisfaction score (aOR: 2.64, 1.67 to 4.17).
Limitations Information about PPT was collected retrospectively and concerned general therapy characteristics. Subsequently no adjustment for therapy for the individual participants could be made.
Conclusions Four predictors for response to PPT in infants of 2-4 months of age with positional preference and/or skull deformation were identified. Health professionals can use these predictors in daily practice to provide infants with more individualized therapy, resulting in better chances of a good outcome
AB - Background Pediatric physical therapy (PPT) seems to reduce skull deformation in infants with positional preference. However, not all infants show improvement.
Objective The purpose of this study was to determine which infant and parent characteristics were related to response to PPT in 2-4 month-old infants with positional preference and/or skull deformation.
Design A prospective cohort study.
Methods Infants 2–4 months old with positional preference and/or skull deformation were recruited by pediatric physical therapists at the start of PPT. Primary outcome was good or poor response (moderate/severe skull deformation) at 4.5 to 6.5 months of age. Potential predictors for response to PPT were assessed at baseline using questionnaires, plagiocephalometry, and the Alberta Infant Motor Scale. Univariate and multiple logistic regression analyses using a stepwise backward elimination method were performed.
Results 657 infants participated in the study. At follow-up 364 infants (55.4%) showed poor response and 293 infants (44.6%) good response to therapy. Multiple logistic regression analysis resulted in the identification of four significant predictors at baseline for poor response to PPT: starting therapy after 3 months of age (adjusted odds ratio [aOR]: 1.50, 95% CI 1.04 to 2.17), skull deformation (plagiocephaly (aOR: 2.64, 1.67 to 4.17), brachycephaly (aOR: 3.07, 2.09 to 4.52)) and a low parental satisfaction score (aOR: 2.64, 1.67 to 4.17).
Limitations Information about PPT was collected retrospectively and concerned general therapy characteristics. Subsequently no adjustment for therapy for the individual participants could be made.
Conclusions Four predictors for response to PPT in infants of 2-4 months of age with positional preference and/or skull deformation were identified. Health professionals can use these predictors in daily practice to provide infants with more individualized therapy, resulting in better chances of a good outcome
KW - METIS-303743
KW - IR-91206
U2 - 10.2522/ptj.20130304
DO - 10.2522/ptj.20130304
M3 - Article
VL - 94
SP - 1262
EP - 1271
JO - Physical therapy
JF - Physical therapy
SN - 0031-9023
IS - 9
ER -