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Helmet therapy for positional cranial deformations; a 5-year follow-up study
Cas van Cruchten1, Michelle Marlena Wilhelmina Feijen1, Rene Remmelt Willie Johan van der Hulst2
1Zuyderland Medisch Centrum, Sittard-Geleen, Plastic Surgery, MC, Dr. H. van der Hoffplein 1, 6162 BG Geleen, the Netherlands.
Insights
Helmet therapy effectively treats positional cranial deformation in infants. Long-term studies show significant improvement in conditions like plagiocephaly and brachycephaly, especially when combined with physical therapy.
Area of Science:
- Pediatrics
- Craniofacial Surgery
- Developmental Biology
Background:
- Positional cranial deformation, including plagiocephaly and brachycephaly, is a common condition in infants.
- Early intervention is crucial for optimal head shape development.
- Various therapeutic approaches exist, ranging from watchful waiting to physical therapy and helmet therapy.
Purpose of the Study:
- To evaluate the long-term efficacy of helmet therapy for positional cranial deformation.
- To assess changes in head shape over a 5-year period in children treated for plagiocephaly and brachycephaly.
- To compare the outcomes of different treatment modalities, including helmet therapy, physical therapy, and combined approaches.
Main Methods:
- Longitudinal study evaluating head shapes in children with positional cranial deformation over a 5-year interval.
- Measurement of cranial shape using plagiocephalometry before and after therapy.
- Inclusion of infants diagnosed with positional plagiocephaly or brachycephaly receiving varied treatments.
Main Results:
- Significant reduction in the prevalence and severity of both positional plagiocephaly (P = 0.031) and positional brachycephaly (P < 0.001) over time.
- Average relative reductions of 194.5% in ODDI (P = 0.001) and 878.4% in CPI (P < 0.001) were observed.
- While ODDI and CPI reductions did not significantly differ between treatment groups, ODDI showed significant improvement with any therapy compared to no therapy, particularly with combined physical and helmet therapy (P < 0.001).
Conclusions:
- Helmet therapy, especially when combined with physical therapy, demonstrates significant long-term benefits in treating positional plagiocephaly and brachycephaly.
- The study supports the use of helmet therapy as an effective intervention for improving cranial shape in infants.
- Continued evaluation of head shape over time confirms the positive impact of therapeutic interventions on positional cranial deformation.
Abstract:
The aim of this study was to assess the long-term effects of helmet therapy in its use for positional cranial deformation, such as plagiocephaly and brachycephaly, by evaluating head shapes in children with a 5-year interval. These children were included at a neonatal age, with a deviating cranial shape classified as positional deformation, and received different forms of therapy, varying from none to physical and helmet therapy combined. Cranial shape was measured before and after therapy, using plagiocephalometry. Both positional plagiocephaly and positional brachycephaly decrease significantly in prevalence and severity over time (P = 0.031 and P < 0.001, respectively), with average relative reductions of 194.5% in ODDI (P = 0.001) and of 878.4% in CPI (P < 0.001). Although the decrease in ODDI and CPI did not significantly vary between treatment methods, ODDI is shown to significantly decrease in case of therapy opposed to no therapy, especially if treatment consists of both physical therapy and helmet therapy (P < 0.001). The long-term effects of therapy are therefore beneficial in the treatment of positional plagiocephaly and will increase the reduction in ODDI, especially in case of both physical and helmet therapy.
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