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Published on: February 5, 2019
Molding therapy of positional plagiocephaly: subjective outcome and quality of life
Bastiaan Govaert1, Alice Michels, Carlo Colla
1Department of Plastic, Reconstructive and Hand Surgery, University Hospital Maastricht, Maastricht, The Netherlands. basgovaert@hotmail.com
Insights
Molding helmet therapy (MHT) for positional plagiocephaly in children showed no adverse effects on quality of life (QOL). Parents reported significant satisfaction with head shape improvements after MHT.
Area of Science:
- Pediatric Plastic Surgery
- Craniofacial Abnormalities
- Quality of Life Research
Background:
- Positional plagiocephaly is a common condition in infants.
- Molding helmet therapy (MHT) is a primary treatment for moderate to severe cases.
- Evaluating treatment outcomes, including quality of life and parental satisfaction, is crucial.
Purpose of the Study:
- To assess the quality of life (QOL) in children treated with MHT for positional plagiocephaly.
- To evaluate parental satisfaction with head shape outcomes post-MHT.
- To compare QOL in treated children with a healthy control group.
Main Methods:
- Retrospective chart review of 166 children treated at a craniofacial clinic.
- Administration of the TAPQOL questionnaire to assess QOL.
- Parental satisfaction questionnaires regarding head shape before and after MHT.
Main Results:
- No significant difference in QOL scores between children treated with MHT and a healthy control group.
- Parents reported a significant increase in satisfaction with head shape after MHT (average rating from 3.6 to 7.5).
- 96% of parents would recommend or repeat MHT, citing positive results and therapy experience.
Conclusions:
- MHT for severe positional plagiocephaly does not negatively impact long-term QOL in children.
- MHT effectively improves head shape and parental satisfaction.
- The therapy is generally well-tolerated and yields satisfactory outcomes.
Abstract:
To evaluate quality of life (QOL) and parental satisfaction in children diagnosed and treated with molding helmet therapy (MHT) for positional plagiocephaly, a retrospective chart research was performed on 166 children who had visited the craniofacial outpatient clinic in the University Hospital of Maastricht between 2002 and 2003. Two questionnaires were sent to parents of these children. The first was used to measure QOL (TAPQOL questionnaire) and was related to a healthy control group. The second evaluated parents' satisfaction concerning the shape of their children's head before and after treatment. One hundred forty-two children were diagnosed with positional plagiocephaly. The group consisted of 111 boys (78.2%) and 31 girls (21.8%). Ninety-eight patients were treated by MHT and 44 had no treatment. Indications for treatment were an ARGENTA classification of type 3 or worse and subjective rating of head shape by the parents. Parents of all children treated with MHT were sent both questionnaires. Forty-six parents (response rate 47%) returned the questionnaires. This group consisted of 39 boys and eight girls. The healthy control group consisted of 251 children between the ages of 1 and 5 years and was used to validate the questionnaire in a previous study. There were no significant differences in QOL scores between the healthy control group and children treated with molding helmet therapy (P > 0.05). Parents gave an average rating of 3.6 before therapy and 7.5 after therapy, a difference of 3.9. Of 46 parents whose children had MHT, only two would not repeat or recommend this therapy. Reasons were unsatisfying result and, in one case, serious pressure spots with hair loss. The population in this study was similar to other studies. Results showed no difference in QOL between treated children and a healthy control group. This study showed that MHT in children with severe positional plagiocephaly does not have long-term adverse effects on QOL. Differences in subjective rating show that MHT has a good result on head shape. A 96% satisfaction rate shows that it is a pleasant therapy and gives a satisfying result.
