Physiotherapy Educational Intervention for Occipital Positional Plagiocephaly Prevention: a Multicentre Randomised Controlled Trial

Questions What 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? Design Two-arm assessor-blind multicentre, randomised controlled trial. Participants 400 pregnant women Intervention The 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. Results Three 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. Conclusion A 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on digital self-treatment, reducing the intervention's impact; thus, the face-to-face model for low-risk infants may be outdated.