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Use of a Midliner Positioning System for Prevention of Dolichocephaly in Preterm Infants
Dana B McCarty1, Shannon OʼDonnell, Ricki F Goldstein
1Division of Physical Therapy (Dr McCarty), Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Physical Therapy and Occupational Therapy (Dr O'Donnell), Duke Clinical Research Institute (Dr Smith), and Department of Pediatrics/Neonatology (Drs Fisher and Malcolm), Duke University Medical Center, Durham, North Carolina; Department of Pediatrics/Neonatology (Dr Goldstein), Kentucky Children's Hospital/University of Kentucky, Lexington, Kentucky.
Purpose:
The purpose of this study was to determine effectiveness of a midliner positioning system (MPS, Tortle Midliner) for preventing dolichocephaly.
Methods:
This was a nonrandomized, prospective study of 30 premature infants (study cohort, SC) using an MPS compared with a retrospective study cohort (RSC) of 65 infants who received standard of care intervention.
Results:
RSC baseline cranial index (CI) of 80% and final CI of 77% significantly decreased over an average 5.5 weeks (P < .0001). The SC baseline CI and the final CI were both 79% over an average 5.7 weeks, indicating no significant difference between CI measures (P = .6). Gestational age, birth weight, reflux, time on continuous positive airway pressure, and time in a supine position were not associated with dolichocephaly.
Conclusions:
The SC developed less cranial molding (ie, had greater CI), compared with the RSC. A larger randomized study is needed to recommend routine use of MPS for prevention and/or treatment of cranial molding in premature infants.
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