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Published on: September 21, 2017
Comparison of helmet therapy and counter positioning for deformational plagiocephaly
Se Yon Kim1, Moon-Sung Park2, Jeong-In Yang3
1The Clinic for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea.
Insights
Helmet therapy is more effective than counter positioning for correcting moderate to severe deformational plagiocephaly (DP) and ear asymmetry. Both methods improved cranial asymmetry without impacting head growth.
Area of Science:
- Pediatric orthopedics
- Craniofacial abnormalities
- Biomechanical engineering
Background:
- Deformational plagiocephaly (DP) is a common condition in infants.
- Cranial and ear asymmetry can result from DP.
- Treatment options include helmet therapy and counter positioning.
Purpose of the Study:
- To compare the effectiveness of helmet therapy versus counter positioning in correcting cranial and ear asymmetry in infants with DP.
Main Methods:
- Retrospective review of 27 infants (≤10 months) diagnosed with DP and ≥10 mm diagonal difference.
- Data collected via 3D laser scans at therapy initiation and termination.
- Measurements included head circumference, diagonal difference, cranial vault asymmetry index, radial symmetry index, and ear shift.
Main Results:
- Both helmet therapy (21 infants) and counter positioning (6 infants) improved cranial asymmetry.
- Helmet therapy showed significantly greater improvement in cranial and ear asymmetry.
- No significant difference in head circumference growth was observed between groups.
Conclusions:
- Helmet therapy is more effective for correcting moderate to severe DP-related cranial and ear asymmetry.
- Treatment outcomes did not compromise head growth in either group.
Objective:
To compare effectiveness on correcting cranial and ear asymmetry between helmet therapy and counter positioning for deformational plagiocephaly (DP).
Methods:
Retrospective data of children diagnosed with DP who visited our clinic from November 2010 to October 2012 were reviewed. Subjects ≤10 months of age who showed ≥10 mm of diagonal difference were included for analysis. For DP treatment, information on both helmet therapy and counter positioning was given and either of the two was chosen by each family. Head circumference, cranial asymmetry measurements including diagonal difference, cranial vault asymmetry index, radial symmetry index, and ear shift were obtained by 3-dimensional head-surface laser scan at the time of initiation and termination of therapy.
Results:
Twenty-seven subjects were included: 21 had helmet therapy and 6 underwent counter positioning. There was no significant difference of baseline characteristics, head circumferences and cranial asymmetry measurements at the initiation of therapy. The mean duration of therapy was 4.30±1.27 months in the helmet therapy group and 4.08±0.95 months in the counter positioning group (p=0.770). While cranial asymmetry measurements improved in both groups, significantly more improvement was observed with helmet therapy. There was no significant difference of the head circumference growth between the two groups at the end of therapy.
Conclusion:
Helmet therapy resulted in more favorable outcomes in correcting cranial and ear asymmetry than counter positioning on moderate to severe DP without compromising head growth.
