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Resource Material: Cranial Remolding Orthoses

Cranial presentation Sean Greer

BEYOND COSMETIC CONCERNS
FUNCTIONAL DEFICITS ASSOCIATED WITH DEFORMATIONAL PLAGIOCEPHALY

Phil Stevens, MEd, CPO, FAAOP
https://opedge.com/Articles/ViewArticle/2012-04_02
This article outlines the potential risks for untreated head shape asymmetry. This includes Otitis media, TMJ, headaches, visual defects, auditory processing disorders, and correlation with developmental delay.

An Overview of Positional Plagiocephaly and Cranial Remolding Orthoses
Fish, Deanna MS, CPO; Lima, Dulcey CO, OTR/L https://journals.lww.com/jpojournal/Fulltext/2003/04000/An_Overview_of_Positional_Plagiocephaly_and.2.aspx
This article provides an in depth introduction to cranial remolding and the concepts involved in evaluating and treating the condition. The full article is available for download.

Cranial Growth Unrestricted During Treatment of Deformational Plagiocephaly
Kelly Keven M.;Littlefield, Timothy R.; Pomitto,Jeanne K.; Manwaring, Kim H.;Beals,Stephen P.
https://journals.lww.com/jcraniofacialsurgery/Citation/2000/11020/Cranial_Growth_Unrestricted_During_Treatment_of.20.aspx
This article shows that cranial remolding helmets do not restrict brain growth during use, instead it only redirects brain growth.

Effectiveness of Conservative Therapy and Helmet Therapy for Positional Cranial Deformation
Steinberg, Jordan P. M.D., Ph.D.; Rawlani, Roshni B.A.; Humphries, Laura S. M.D.; Rawlani, Vinay M.D.; Vicari, Frank A. M.D.
https://pdfs.semanticscholar.org/22a0/b49bad0cb77c67d1afde69818c4981d4768b.pdf
This article shows that conservative and helmet therapy are effective in correcting head shapes. It also emphasizes that helmets should be emphasized in cases when risk factors for conservative treatment failure are present. This article also describes head shape asymmetry as a volumetric deficit, measurable with 3D scanning technology.

Evidence-Based Care of the Child With Deformational Plagiocephaly, Part II: Management
Amanda B. Kack Flannery, MS, RN, CNP,Wendy S. Looman, PhD, RN, CNP,
& Kristin Kemper, MS, RN, CNP
https://www.jpedhc.org/article/S0891-5245%2811%2900366-X/fulltext?code=ymph-site
This article reviews and grades the literature with regards to treatment of deformational plagiocephaly from 2000 to 2011. A large focus is on timing of treatment and the role of physical therapy

Incidence of Cranial Asymmetry in Healthy Newborns
Wiebke K. Peitsch, Constance H. Keefer, Richard A. LaBrie and John B. Mulliken
http://pediatrics.aappublications.org/content/pediatrics/110/6/e72.full.pdf
This article reports that positional plagiocephaly rates in healthy single born children is approximately 13%, whereas in twins the rate is as high as 56%.

Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review
Bialocerkowski AE, Vladusic SL, Wei Ng C.
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1469-8749.2008.03029.x
This article was a systematic review of english language literature from 1985 through 2007 useful in identifying risk factor associated with positional plagiocephaly. These include being male, first born, and twins.

Neurodevelopmental Implications of “Deformational” Plagiocephaly
Brent Collett, Ph.D., David Breiger, Ph.D., Darcy King, ARNP, Michael
Cunningham, M.D., Ph.D., and Matthew Speltz, Ph.D.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393045/pdf/nihms386844.pdf
This article shows that children with plagiocephaly were more likely to require special education services in school than their non-affected siblings, as well as speech, occupational and physical therapy services. These results are similar to findings in children with single suture synostosis.

Comparison of Infant Head Shape Changes in Deformational Plagiocephaly Following Treatment With a Cranial Remolding Orthosis Using a Noninvasive Laser Shape Digitizer
Laura H. Plank, CO, Brian Giavedoni, MBA, CP, Janet R. Lombardo, MBA, CPO, Mark D. Geil, PhD, Andrew Reisner, MD, FACS, FAAP
https://www.orthomerica.com/pdf/articles/JCS%20Scanner%20Article.pdf
This article outlines the beginning of the Children’s Healthcare of Atlanta (CHOA) scale for determining severity of head shape asymmetry using 3D scanner technology.

Cranial Remolding Helmet Treatment of Plagiocephaly: Comparison of Results and Treatment Length in Younger Versus Older Infant Populations
Katrina Grigsby, BS
http://regispthomeexerciseprograms.pbworks.com/f/helmet%20therapy.pdf
This article shows that patient’s who begin treatment at younger ages complete the treatment nearly twice as fast as children who start the treatment at older ages (approx 6 months vs 10 months) and have greater correction of the deformity.

Click to Download:Miller Cranial Assessment

Click to Download: Clinical Classification Scale Miller

Click to Download: Cephalic Ratio Calculations Miller

orthomericahelmetinstructions_p32-35

ORTH_961942_PlagiocephalyScale_BWInfo

Kristin Vicari – STARScale and Critical Age

endoscopically assisted strip craniectomy

BMJ-NYT-Netherlands-pics

BMJ helmet response

Argenta Classification