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Child's Nervous System

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01-08-2017 | Original Paper

Relationship between starting age of cranial-remolding-orthosis therapy and effectiveness of treatment in children with deformational plagiocephaly

Authors: Mi-hyang Han, Jin Young Kang, Hye Young Han, Yun-hwa Cho, Dae-Hyun Jang

Published in: Child's Nervous System | Issue 8/2017

Abstract

Purpose

The aim of this study was to investigate the optimal age for starting cranial-remolding-orthosis therapy in children with deformational plagiocephaly.

Methods

Medical records of 310 patients with deformational plagiocephaly were retrospectively reviewed and the initial and final cranial vault asymmetry index (CVAI), age when starting therapy, duration of therapy, mean change of CVAI, improvement rate, and treatment success were analyzed. We compared outcomes according to the groups divided by ages starting therapy.

Results

There were no significant differences in improvement rate and duration of cranial-remolding-orthosis therapy among patients starting therapy at the age of 3, 4, and 5 months. However, when starting therapy after the age of 6 months, the rates of CVAI improvement were significantly lower and the duration of therapy was significantly increased.

Conclusion

Considering the spontaneous resolution effect according to the head growth nature, the age 5 month is the optimal period to start cranial-remolding-orthosis therapy for deformational plagiocephaly.

Kelly KM, Littlefield TR, Pomatto JK, Manwaring KH, Beals SP (1999) Cranial growth unrestricted during treatment of deformational plagiocephaly. Pediatr Neurosurg 30:193–199. doi: 28794

Bialocerkowski AE, Vladusic SL, Wei Ng C (2008) Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review. Dev Med Child Neurol 50:577–586. doi:10.1111/j.1469-8749.2008.03029.x CrossRefPubMed

Looman WS, Flannery AB (2012) Evidence-based care of the child with deformational plagiocephaly, part I: assessment and diagnosis. J Pediatr Health Care 26:242–250; quiz 251-243. doi:10.1016/j.pedhc.2011.10.003 CrossRefPubMed

Mortenson P, Steinbok P, Smith D (2012) Deformational plagiocephaly and orthotic treatment: indications and limitations. Childs Nerv Syst 28:1407–1412. doi:10.1007/s00381-012-1755-3 CrossRefPubMed

Aihara Y, Komatsu K, Dairoku H, Kubo O, Hori T, Okada Y (2014) Cranial molding helmet therapy and establishment of practical criteria for management in Asian infant positional head deformity. Childs Nerv Syst 30:1499–1509. doi:10.1007/s00381-014-2471-y CrossRefPubMed

Speltz ML, Collett BR, Stott-Miller M, Starr JR, Heike C, Wolfram-Aduan AM, King D, Cunningham ML (2010) Case-control study of neurodevelopment in deformational plagiocephaly. Pediatrics 125:e537–542. doi:10.1542/peds.2009-0052

Collett BR, Gray KE, Starr JR, Heike CL, Cunningham ML, Speltz ML (2013) Development at age 36 months in children with deformational plagiocephaly. Pediatrics 131:e109–e115. doi:10.1542/peds.2012-1779 CrossRefPubMedPubMedCentral

Cabrera-Martos I, Valenza MC, Valenza-Demet G, Benitez-Feliponi A, Robles-Vizcaino C, Ruiz-Extremera A (2016) Effects of manual therapy on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly: a randomised controlled pilot study. Childs Nerv Syst 32:2211–2217. doi:10.1007/s00381-016-3200-5

Dorhage KW, Beck-Broichsitter BE, von Grabe V, Sonntag A, Becker ST, Wiltfang J (2016) Therapy effects of head orthoses in positional plagiocephaly. J Craniomaxillofac Surg 44:1508–1514. doi:10.1016/j.jcms.2016.06.035 CrossRefPubMed

10.

Graham JM Jr, Gomez M, Halberg A, Earl DL, Kreutzman JT, Cui J, Guo X (2005) Management of deformational plagiocephaly: repositioning versus orthotic therapy. J Pediatr 146:258–262. doi:10.1016/j.jpeds.2004.10.016 CrossRefPubMed

11.

Kluba S, Kraut W, Reinert S, Krimmel M (2011) What is the optimal time to start helmet therapy in positional plagiocephaly? Plast Reconstr Surg 128:492–498. doi:10.1097/PRS.0b013e31821b62d6 CrossRefPubMed

12.

Thompson JT, David LR, Wood B, Argenta A, Simpson J, Argenta LC (2009) Outcome analysis of helmet therapy for positional plagiocephaly using a three-dimensional surface scanning laser. J Craniofac Surg 20:362–365. doi:10.1097/SCS.0b013e3181992382 CrossRefPubMed

13.

Mulliken JB, Vander Woude DL, Hansen M, LaBrie RA, Scott RM (1999) Analysis of posterior plagiocephaly: deformational versus synostotic. Plast Reconstr Surg 103:371–380CrossRefPubMed

14.

Plank LH, Giavedoni B, Lombardo JR, Geil MD, Reisner A (2006) Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer. J Craniofac Surg 17:1084–1091. doi:10.1097/01.scs.0000244920.07383.85

15.

Freudlsperger C, Steinmacher S, Saure D, Bodem JP, Kuhle R, Hoffmann J, Engel M (2016) Impact of severity and therapy onset on helmet therapy in positional plagiocephaly. J Craniomaxillofac Surg 44:110–115. doi:10.1016/j.jcms.2015.11.016 CrossRefPubMed

16.

Yoo HS, Rah DK, Kim YO (2012) Outcome analysis of cranial molding therapy in nonsynostotic plagiocephaly. Arch Plast Surg 39:338–344. doi:10.5999/aps.2012.39.4.338 CrossRefPubMedPubMedCentral

17.

Clarren SK, Smith DW, Hanson JW (1979) Helmet treatment for plagiocephaly and congenital muscular torticollis. J Pediatr 94:43–46CrossRefPubMed

18.

Loveday BP, de Chalain TB (2001) Active counterpositioning or orthotic device to treat positional plagiocephaly? J Craniofac Surg 12:308–313CrossRefPubMed

19.

Clarren SK (1981) Plagiocephaly and torticollis: etiology, natural history, and helmet treatment. J Pediatr 98:92–95CrossRefPubMed

20.

Littlefield TR (2001) Food and Drug Administration regulation of orthotic cranioplasty. Cleft Palate Craniofac J 38:337–340. doi:10.1597/1545-1569(2001)038<0337:fadaro>2.0.co;2 CrossRefPubMed

21.

van Wijk RM, van Vlimmeren LA, Groothuis-Oudshoorn CG, Van der Ploeg CP, Ijzerman MJ, Boere-Boonekamp MM (2014) Helmet therapy in infants with positional skull deformation: randomised controlled trial. Bmj 348:g2741. doi:10.1136/bmj.g2741

22.

Bruner TW, David LR, Gage HD, Argenta LC (2004) Objective outcome analysis of soft shell helmet therapy in the treatment of deformational plagiocephaly. J Craniofac Surg 15:643–650CrossRefPubMed

23.

Kim SY, Park MS, Yang JI, Yim SY (2013) Comparison of helmet therapy and counter positioning for deformational plagiocephaly. Ann Rehabil Med 37:785–795. doi:10.5535/arm.2013.37.6.785 CrossRefPubMedPubMedCentral

24.

Xia JJ, Kennedy KA, Teichgraeber JF, Wu KQ, Baumgartner JB, Gateno J (2008) Nonsurgical treatment of deformational plagiocephaly: a systematic review. Arch Pediatr Adolesc Med 162:719–727. doi:10.1001/archpedi.162.8.719

25.

Kluba S, Kraut W, Calgeer B, Reinert S, Krimmel M (2014) Treatment of positional plagiocephaly--helmet or no helmet? J Craniomaxillofac Surg 42:683–688. doi:10.1016/j.jcms.2013.09.015 CrossRefPubMed

26.

Miller RI, Clarren SK (2000) Long-term developmental outcomes in patients with deformational plagiocephaly. Pediatrics 105:E26

27.

Robinson S, Proctor M (2009) Diagnosis and management of deformational plagiocephaly. J Neurosurg Pediatr 3:284–295. doi:10.3171/2009.1.peds08330

28.

Lee RP, Teichgraeber JF, Baumgartner JE, Waller AL, English JD, Lasky RE, Miller CC, Gateno J, Xia JJ (2008) Long-term treatment effectiveness of molding helmet therapy in the correction of posterior deformational plagiocephaly: a five-year follow-up. Cleft Palate Craniofac J 45:240–245. doi:10.1597/06-210.1

Title: Relationship between starting age of cranial-remolding-orthosis therapy and effectiveness of treatment in children with deformational plagiocephaly
Authors: Mi-hyang Han
Jin Young Kang
Hye Young Han
Yun-hwa Cho
Dae-Hyun Jang
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 8/2017
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-017-3427-9

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Relationship between starting age of cranial-remolding-orthosis therapy and effectiveness of treatment in children with deformational plagiocephaly

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

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