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Published on: September 21, 2017
Effect of helmet therapy in the treatment of positional head deformity
Juan Wen1,2, Jun Qian1, Lei Zhang1
1Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
Insights
Helmet therapy significantly improves infant head shape deformities compared to postural correction. This treatment is effective and does not impede head circumference growth in infants.
Area of Science:
- Pediatric Orthopedics
- Craniofacial Development
- Infant Health
Background:
- Positional head deformities are common in infants.
- Conservative treatments include postural correction and helmet therapy (head orthosis).
- Effectiveness of helmet therapy versus postural correction requires further investigation.
Purpose of the Study:
- To compare the cosmetic improvement of infant head deformities treated with helmet therapy versus postural correction training.
- To evaluate the efficacy of helmet therapy in improving specific cranial measurements.
Main Methods:
- Retrospective cohort studies involving 56 infants with plagiocephaly, brachycephaly, or asymmetrical brachycephaly.
- Comparison of cephalic ratio (CR), radial symmetry index (RSI), cranial vault asymmetry (CVA), and cranial vault asymmetry index (CVAI) before and after treatment.
- Analysis of head circumference growth between treatment groups.
Main Results:
- No significant baseline differences in cranial measurements between groups.
- Helmet therapy group showed significant improvements in CR, RSI, CVA, and CVAI compared to postural correction.
- No significant difference in head circumference growth was observed between the groups.
Conclusions:
- Helmet therapy appears more effective than postural correction for treating mild-moderate-severe positional head deformities in infants.
- Helmet therapy is a safe option that does not negatively impact infant head circumference growth.
Aim:
Most positional head deformities can be treated conservatively with postural correction training or a head orthosis ('helmet'). We aimed to investigate whether infants with helmet therapy have cosmetic improvement in head deformity.
Methods:
A total of 376 infants at age 2-40 months who were diagnosed with mild-moderate-severe positional head deformity were enrolled. Among these infants, 101 infants were treated with helmet therapy or postural correction training. After matching by infant's age and time of therapy, three retrospective cohort studies of 56 infants were conducted for infants with plagiocephaly, brachycephaly and asymmetrical brachycephaly, respectively. The cephalic ratio (CR), radial symmetry index (RSI), cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI) were compared between two groups before and after treatment.
Results:
Before treatment, no significant differences in CR, RSI, CVA and CVAI between groups were found. After treatment, compared with the postural correction training group, the helmet therapy group had significant improvements in CR, RSI, CVA or CVAI (Plagiocephaly: PCVA = 0.017, PCVAI = 0.028; Brachycephaly: PCR = 0.002; Asymmetrical brachycephaly: PRSI = 0.002, PCVA < 0.001, PCVAI < 0.001). Moreover, there was no significant difference in head circumference growth between the groups.
Conclusions:
Helmet therapy may be more effective in the treatment of mild-moderate-severe positional head deformity than postural correction training in infants. And helmet therapy may not hinder head circumference growth.
