Conservative Management of Nonsynostotic Plagiocephaly in Infants: A Literature Review with Focus on Osteopathic and Manual Therapy
Abstract
Background
Nonsynostotic plagiocephaly is one of the most common cranial deformities observed in infants. The condition is characterized by unilateral flattening of the occipital region of the skull resulting from prolonged external mechanical pressure. In recent decades, the prevalence of positional plagiocephaly has increased significantly, largely due to the introduction of supine sleeping recommendations following the “Back to Sleep” campaign aimed at reducing sudden infant death syndrome.
Objective
The aim of this literature review was to evaluate conservative therapeutic approaches used in infants with nonsynostotic plagiocephaly, with particular emphasis on osteopathic and manual therapy, and to analyze their influence on cranial symmetry, cervical mobility, and motor development.
Materials and Methods
A narrative literature review was conducted using PRISMA-informed screening principles. The PubMed database was searched using a broad exploratory strategy to identify studies related to plagiocephaly and cranial asymmetry in infants. Studies evaluating conservative therapeutic interventions in infants with positional plagiocephaly were screened for eligibility according to predefined inclusion and exclusion criteria.
Results
A total of 5620 publications were initially identified. After screening procedures and application of inclusion criteria, 21 studies were included in the qualitative analysis. The analyzed literature suggests that conservative therapeutic interventions may improve cranial symmetry and functional outcomes in infants with positional plagiocephaly. In particular, osteopathic and manual therapies demonstrated potential benefits in improving cranial asymmetry, cervical mobility, and motor development.
Conclusions
Conservative therapeutic approaches appear to be important in the management of nonsynostotic plagiocephaly. Osteopathic and manual therapy may represent safe and potentially effective components of multidisciplinary treatment; however, further randomized controlled trials are required to establish standardized treatment protocols and evaluate long-term outcomes.
© 2026 Anna Paulina Skomro, Marzena Ewa Mańdziuk, published by SAN University
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