A team of O&P clinicians conducted a retrospective review of outcomes using the Michigan Cranial Reshaping Orthosis to treat infants for positional cranial asymmetry involving plagiocephaly, brachycephaly, and scaphocephaly. The Michigan Cranial Reshaping Orthosis is a bivalve helmet that accommodates overall cranial growth during the therapy period while still directing cranial growth toward the desired areas. This design differs from standard one-piece helmets that allow limited volume for overall cranial growth. The results of the study were published in the October 2015 issue of the Journal of Prosthetics and Orthotics.
According to the study abstract, 70 subjects treated for plagiocephaly and/or brachycephaly with the Michigan Cranial Reshaping Orthosis were identified. Data was compiled from a WillowWood Omega Tracer computer-aided design clinical database of 3D cranial scans taken before and after helmet therapy. The cranial helmet therapy treatment timeline was verified through the electronic medical record database. Cranial landmarks were defined on each 3D image. Measurements between defined points were compared on the initial assessment scanned image and the final discharge scanned image for each patient. Visual inspection and manual measurements taken throughout the helmet therapy period using a flexible tape measure and an AP-ML gauge indicated significant cranial asymmetry correction. However, measurement inconsistencies due to soft tissue compression and clinician technique may limit the accuracy of outcome measures.
According to the study results, comparison of initial and final 3D scans showed improved symmetry in the relevant measures of cranial vault asymmetry index (CVAI) and cephalic ratio (CR) in 84.3 percent of the subjects. Children in the plagiocephaly-only group showed 28.8 percent improvement in CVAI. Although sample size was low, children in the brachycephaly-only group showed 4.66 percent improvement in CR. Children in the combined plagiocephaly/brachycephaly group showed 41.4 percent improvement in CVAI and 2.6 percent improvement in CR. Overall, a 33.5 percent improvement in CVAI and a 2.1 percent improvement in CR were seen. These results are comparable to other studies of remolding helmet efficacy, the study authors said.
Given these results, the study authors concluded that the data supports the use of the Michigan Cranial Reshaping Orthosis as a viable option to treat plagiocephaly and/or brachycephaly when the primary method of treatment is utilization of a cranial remolding helmet.
