Researchers investigated the clinical effectiveness of cranial molding orthotic treatment for infants with plagiocephaly and the parents’ perspectives of the treatment. The research team found that a high percentage of parents felt that the treatment met their initial goals in spite of any adverse events. Parents perceived that cranial molding orthoses were more effective when their children had severe initial skull asymmetry and when the orthoses were applied earlier in infancy.
A retrospective medical chart review was conducted for 82 infants treated for plagiocephaly with cranial molding orthoses at a clinic in Seoul, Korea, from April 2012 to July 2016. Infants who were clinically diagnosed with positional plagiocephaly and had a cranial vault asymmetry index (CVAI) of more than 3.5 percent were included. Pre- and post-treatment CVAI was obtained with a Vorum 3D laser scanner. The infants’ mean age at the initiation of cranial molding orthotic therapy was 24.3 weeks (± 8.4 weeks).
Parents’ perceptions of good outcome (satisfaction) were evaluated with the Goal Attainment Scale (GAS) to assess how much the parent felt that his or her initial goal for correcting the child’s skull asymmetry was achieved after the treatment. The GAS scoring metric ranged from 2 (much greater than expected outcome) to -2 (much less than expected outcome).
There were 53 infants (65 percent) who had adverse events with the orthoses during the study. Heat rash was the most common adverse effect found in 29 cases (35.4 percent). Orthosis compliance was 90.2 percent (74 of 82 infants). The GAS ratings were converted to a GAS T-score with a mean of 50 and standard deviation of 10. The mean GAS T-score was 51.9 ± 10.2. A GAS T-score of 0 or more was identified for 71.6 percent of parents. The GAS T-score was significantly related to the child’s age, the initial CVAI, and the difference in CVAI during the treatment, according to the study’s authors.
The open-access study was published October 31 in the Annals of Rehabilitation Medicine.