Annals of Rehabilitation Medicine

Korean Academy of Rehabilitation Medicine (대한재활의학회)
권호 표지
DOI QR코드

DOI QR Code

Parents' Perspectives and Clinical Effectiveness of Cranial-Molding Orthoses in Infants With Plagiocephaly

  • Lee, Hyo Sun (Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Sang Jun (Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwon, Jeong-Yi (Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2018.01.12
  • Accepted : 2018.03.15
  • Published : 2018.10.31
⟨ Previous Next ⟩

Abstract

Objective To investigate the clinical effectiveness of and parents' perspectives on cranial-molding orthotic treatment. Methods Medical charts were reviewed for 82 infants treated for plagiocephaly with cranial-molding orthoses in our clinic from April 2012 to July 2016 retrospectively. Infants who were clinically diagnosed with positional plagiocephaly and had a Cranial Vault Asymmetry Index (CVAI) of more than 3.5% were included. Pre- and post-treatment CVAI was obtained by three-dimensional head-surface laser scan. Parents' perceptions of good outcome (satisfaction) were evaluated with the Goal Attainment Scale (GAS). The GAS score assessed how much the parent felt that his or her initial goal for correcting the skull asymmetry was achieved after the treatment. Results The compliance with cranial-molding orthoses was 90.2% (74 of 82 infants). There were 53 infants (65% of the 82 infants) who had adverse events with the cranial-molding orthoses during the study. Heat rash was found in 29 cases (35.4%) and was the most common adverse event. The mean GAS T-score was $51.9{\pm}10.2$. A GAS T-score of 0 or more was identified for 71.6% of parents. The GAS T-score was significantly related to the age (p<0.001), the initial CVAI, and the difference of CVAI during the treatment (p<0.001). Conclusion Parents' perception of good outcome was correlated with the anthropometric improvement in cranial-molding orthotic treatment in infants with plagiocephaly. A high percentage of parents felt that the treatment met their initial goals in spite of a high occurrence of adverse events.

Keywords

Acknowledgement

Grant : Development of ICT-based software platforms and service technologies for medical 3D-printing applications

Supported by : IITP

References

  1. Ellenbogen RG, Gruss JS, Cunningham ML. Update on craniofacial surgery: the differential diagnosis of lambdoid synostosis/posterior plagiocephaly. Clin Neurosurg 2000;47:303-18.
  2. Mortenson P, Steinbok P, Smith D. Deformational plagiocephaly and orthotic treatment: indications and limitations. Childs Nerv Syst 2012;28:1407-12. https://doi.org/10.1007/s00381-012-1755-3
  3. Looman WS, Flannery AB. Evidence-based care of the child with deformational plagiocephaly, Part I: assessment and diagnosis. J Pediatr Health Care 2012;26:242-50. https://doi.org/10.1016/j.pedhc.2011.10.003
  4. Hutchison BL, Hutchison LA, Thompson JM, Mitchell EA. Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study. Pediatrics 2004;114:970-80. https://doi.org/10.1542/peds.2003-0668-F
  5. Collett B, Breiger D, King D, Cunningham M, Speltz M. Neurodevelopmental implications of “deformational” plagiocephaly. J Dev Behav Pediatr 2005;26:379-89. https://doi.org/10.1097/00004703-200510000-00008
  6. Boere-Boonekamp MM, van der Linden-Kuiper LT. Positional preference: prevalence in infants and follow- up after two years. Pediatrics 2001;107:339-43. https://doi.org/10.1542/peds.107.2.339
  7. Robinson S, Proctor M. Diagnosis and management of deformational plagiocephaly. J Neurosurg Pediatr 2009;3:284-95.
  8. Tamber MS, Nikas D, Beier A, Baird LC, Bauer DF, Durham S, et al. Congress of neurological surgeons systematic review and evidence-based guideline on the role of cranial molding orthosis (Helmet) therapy for patients with positional plagiocephaly. Neurosurgery 2016;79:E632-E633. https://doi.org/10.1227/NEU.0000000000001430
  9. van Wijk RM, van Vlimmeren LA, Groothuis-Oudshoorn CG, Van der Ploeg CP, Ijzerman MJ, Boere-Boonekamp MM. Helmet therapy in infants with positional skull deformation: randomised controlled trial. BMJ 2014;348:g2741. https://doi.org/10.1136/bmj.g2741
  10. Mulliken JB, Vander Woude DL, Hansen M, LaBrie RA, Scott RM. Analysis of posterior plagiocephaly: deformational versus synostotic. Plast Reconstr Surg 1999;103:371-80. https://doi.org/10.1097/00006534-199902000-00003
  11. Stadnick NA, Drahota A, Brookman-Frazee L. Parent perspectives of an evidence-based intervention for children with autism served in community mental health clinics. J Child Fam Stud 2013;22:414-22. https://doi.org/10.1007/s10826-012-9594-0
  12. Elwood ET, Petronio J, Wood RJ. Parental satisfaction with the CranioCap: a new cranial orthosis for deformational plagiocephaly. Cleft Palate Craniofac J 2005;42:340-3. https://doi.org/10.1597/04-004.1
  13. Katzel EB, Koltz PF, Sbitany H, Girotto JA. Treatment of plagiocephaly with helmet molding therapy: do actual results mimic perception? Cleft Palate Craniofac J 2011;48:205-9. https://doi.org/10.1597/09-209
  14. Loveday BP, de Chalain TB. Active counterpositioning or orthotic device to treat positional plagiocephaly? J Craniofac Surg 2001;12:308-13. https://doi.org/10.1097/00001665-200107000-00003
  15. Mortenson PA, Steinbok P. Quantifying positional plagiocephaly: reliability and validity of anthropometric measurements. J Craniofac Surg 2006;17:413-9. https://doi.org/10.1097/00001665-200605000-00005
  16. Turner-Stokes L. Goal attainment scaling (GAS) in rehabilitation: a practical guide. Clin Rehabil 2009;23:362-70. https://doi.org/10.1177/0269215508101742
  17. Kiresuk TJ, Sherman RE. Goal attainment scaling: a general method for evaluating comprehensive community mental health programs. Community Ment Health J 1968;4:443-53. https://doi.org/10.1007/BF01530764
  18. Rockwood K, Joyce B, Stolee P. Use of goal attainment scaling in measuring clinically important change in cognitive rehabilitation patients. J Clin Epidemiol 1997;50:581-8. https://doi.org/10.1016/S0895-4356(97)00014-0
  19. Wilbrand JF, Wilbrand M, Malik CY, Howaldt HP, Streckbein P, Schaaf H, et al. Complications in helmet therapy. J Craniomaxillofac Surg 2012;40:341-6. https://doi.org/10.1016/j.jcms.2011.05.007
  20. Freudlsperger C, Bodem JP, Kargus S, Castrillon-Oberndorfer G, Hoffman J, Engel M. The incidence of complications associated with molding helmet therapy: an avoidable risk in the treatment of positional head deformities? J Craniofac Surg 2015;26:e299-302. https://doi.org/10.1097/SCS.0000000000001649
  21. de Ribaupierre S, Vernet O, Rilliet B, Cavin B, Kalina D, Leyvraz P. Posterior positional plagiocephaly treated with cranial remodeling orthosis. Swiss Med Wkly 2007;137:368-72.
  22. Vles JS, Colla C, Weber JW, Beuls E, Wilmink J, Kingma H. Helmet versus nonhelmet treatment in nonsynostotic positional posterior plagiocephaly. J Craniofac Surg 2000;11:572-4. https://doi.org/10.1097/00001665-200011060-00010
  23. Kluba S, Kraut W, Calgeer B, Reinert S, Krimmel M. Treatment of positional plagiocephaly: helmet or no helmet? J Craniomaxillofac Surg. 2014;42:683-8. https://doi.org/10.1016/j.jcms.2013.09.015
  24. Freudlsperger C, Steinmacher S, Saure D, Bodem JP, Kuhle R, Hoffmann J, et al. Impact of severity and therapy onset on helmet therapy in positional plagiocephaly. J Craniomaxillofac Surg 2016;44:110-5. https://doi.org/10.1016/j.jcms.2015.11.016
  25. Graham JM Jr, Gomez M, Halberg A, Earl DL, Kreutzman JT, Cui J, et al. Management of deformational plagiocephaly: repositioning versus orthotic therapy. J Pediatr 2005;146:258-62. https://doi.org/10.1016/j.jpeds.2004.10.016
  26. Seruya M, Oh AK, Taylor JH, Sauerhammer TM, Rogers GF. Helmet treatment of deformational plagiocephaly: the relationship between age at initiation and rate of correction. Plast Reconstr Surg 2013;131:55e-61e. https://doi.org/10.1097/PRS.0b013e3182729f11
  27. Bailey DB Jr, Buysse V, Edmondson R, Smith TM. Creating family-centered services in early intervention: perceptions of professionals in four states. Except Child 1992;58:298-309. https://doi.org/10.1177/001440299205800403
  28. King G, King S, Rosenbaum P. Interpersonal aspects of care-giving and client outcomes: a review of the literature. Ambul Child Health 1996;2:151-60.

Cited by

  1. Subjective perception of craniofacial growth asymmetries in patients with deformational plagiocephaly vol.25, pp.2, 2018, https://doi.org/10.1007/s00784-020-03417-y