Positional posterior plagiocephaly: a single-center review

Ahluwalia, Ranbir; Kiely, Chelsea; Foster, John Burt; Gannon, Stephen; Wiseman, Alyssa L; Shannon, Chevis N.; Bonfield, Christopher M.

doi:10.3171/2019.12.peds19651

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…These findings suggest, that, although there may be statistically different values for CVAI measurements in older children, consistent with the literature, there is no clinically significant association between sex and cranial deformation. 7,13 With regard to race, the CVAI measurement was significantly different between African American and Caucasian patients within the 2 cohorts. Additionally, PPP diagnosis rates were significantly higher among the Caucasian population in both cohorts.…”

Section: Discussionmentioning

confidence: 98%

“…4,5,7,11 Most prominently, since the introduction of the Back to Sleep campaign in 1992, a decrease in SIDS-related deaths was seen with a concomitant increase in PPP. 7,10,12,13 While prominent risk factors for these conditions have been assessed, especially obstetric and infant care factors, there have been no formal evaluations of demographic associations across sex, race, and ethnicity. 14 For this reason, we set out to investigate the relationships therein.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric cranial deformations: demographic associations

Foster

Ahluwalia

Sherburn

et al. 2020

Journal of Neurosurgery: Pediatrics

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OBJECTIVENo study has established a relationship between cranial deformations and demographic factors. While the connection between the Back to Sleep campaign and cranial deformation has been outlined, considerations toward cultural or anthropological differences should also be investigated.METHODSThe authors conducted a retrospective review of 1499 patients (age range 2 months to less than 19 years) who presented for possible trauma in 2018 and had a negative CT scan. The cranial vault asymmetry index (CVAI) and cranial index (CI) were used to evaluate potential cranial deformations. The cohort was evaluated for differences between sex, race, and ethnicity among 1) all patients and 2) patients within the clinical treatment window (2–24 months of age). Patients categorized as “other” and those for whom data were missing were excluded from analysis.RESULTSIn the CVAI cohort with available data (n = 1499, although data were missing for each variable), 800 (56.7%) of 1411 patients were male, 1024 (79%) of 1304 patients were Caucasian, 253 (19.4%) of 1304 patients were African American, and 127 (10.3%) of 1236 patients were of Hispanic/Latin American descent. The mean CVAI values were significantly different between sex (p < 0.001) and race (p < 0.001). However, only race was associated with differences in positional posterior plagiocephaly (PPP) diagnosis (p < 0.001). There was no significant difference in CVAI measurements for ethnicity (p = 0.968). Of the 520 patients in the treatment window cohort, 307 (59%) were male. Of the 421 patients with data for race, 334 were Caucasian and 80 were African American; 47 of the 483 patients with ethnicity data were of Hispanic/Latin American descent. There were no differences between mean CVAI values for sex (p = 0.404) or ethnicity (p = 0.600). There were significant differences between the mean CVAI values for Caucasian and African American patients (p < 0.001) and rate of PPP diagnosis (p = 0.02). In the CI cohort with available data (n = 1429, although data were missing for each variable), 849 (56.8%) of 1494 patients were male, 1007 (67.4%) of 1283 were Caucasian, 248 (16.6%) of 1283 were African American, and 138 patients with ethnicity data (n = 1320) of Hispanic/Latin American descent. Within the clinical treatment window cohort with available data, 373 (59.2%) of 630 patients were male, 403 were Caucasian (81.9%), 84 were African American (17.1%), and 55 (10.5%) of 528 patients were of Hispanic/Latin American descent. The mean CI values were not significantly different between sexes (p = 0.450) in either cohort. However, there were significant differences between CI measurements for Caucasian and African American patients (p < 0.001) as well as patients of Hispanic/Latin American descent (p < 0.001) in both cohorts.CONCLUSIONSThe authors found no significant associations between cranial deformations and sex. However, significant differences exist between Caucasian and African American patients as well as patients with Hispanic/Latin American heritage. These findings suggest cultural or anthropological influences on defining skull deformations. Further investigation into the factors contributing to these differences should be undertaken.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Pediatric cranial deformations: demographic associations

Foster

Ahluwalia

Sherburn

et al. 2020

Journal of Neurosurgery: Pediatrics

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“…Prevalence data are limited and depend on the geographic location. However, prevalence seems to be high as the best estimations of the presence of PP in infants range from 20 to 40% [6][7][8].…”

Section: Introductionmentioning

confidence: 98%

Efficacy of Pediatric Integrative Manual Therapy in Positional Plagiocephaly: A Randomized Controlled Trial.

Pastor-Pons

Lucha-López

Barrau-Lalmolda

et al. 2020

Preprint

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Background: positional plagiocephaly frequently affects healthy babies. It is hypothesized that manual therapy tailored to pediatrics is more effective in improving plagiocephalic cranial asymmetry than just repositioning and sensory and motor stimulation. Methods: 34 neurologically healthy subjects aged less than 28 weeks old with a difference of at least 5 mm between cranial diagonal diameters were randomly distributed into 2 groups. For 10 weeks, the pediatric integrative manual therapy (PIMT) group received manual therapy plus a caregiver education program, while the controls received the same education program exclusively. Cranial shape was evaluated using anthropometry; cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated. Parental perception of change was assessed using a visual analogue scale (-10 cm to +10 cm). Results: CVAI presented a greater decrease in PIMT group: 3.72 ± 1.40 % compared with 0.34 ± 1.72% in the controls (p=0.000). CI changes did not present any significant differences between the 2 groups. Manual therapy increased positive parental perception of cranial changes (manual therapy: 6.66 ± 2.07 cm; control: 4.25 ± 2.31 cm; p= 0.004). Conclusion: manual therapy plus caregiver education program improved cranial symmetry and parents’ satisfaction more effectively than solely caregiver education program.Trial registration: trial registration number: NCT03659032; registration date: September 1, 2018. Retrospectively registered.https://clinicaltrials.gov/ct2/show/NCT03659032?term=NCT03659032&cond=Plagiocephaly&draw=2&rank=1

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“…Prevalence data are limited and depend on the geographic location. However, the prevalence seems to be high as the best estimations of the presence of PP in infants range from 20 to 40% [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of pediatric integrative manual therapy in positional plagiocephaly: a randomized controlled trial

et al. 2021

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Background Positional plagiocephaly frequently affects healthy babies. It is hypothesized that manual therapy tailored to pediatrics is more effective in improving plagiocephalic cranial asymmetry than just repositioning and sensory and motor stimulation. Methods Thirty-four neurologically healthy subjects aged less than 28 weeks old with a difference of at least 5 mm between cranial diagonal diameters were randomly distributed into 2 groups. For 10 weeks, the pediatric integrative manual therapy (PIMT) group received manual therapy plus a caregiver education program, while the controls received the same education program exclusively. Cranial shape was evaluated using anthropometry; cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated. Parental perception of change was assessed using a visual analogue scale (− 10 cm to + 10 cm). Results CVAI presented a greater decrease in PIMT group: 3.72 ± 1.40% compared with 0.34 ± 1.72% in the control group (p = 0.000). CI did not present significant differences between groups. Manual therapy led to a more positive parental perception of cranial changes (manual therapy: 6.66 ± 2.07 cm; control: 4.25 ± 2.31 cm; p = 0.004). Conclusion Manual therapy plus a caregiver education program improved CVAI and led to parental satisfaction more effectively than solely a caregiver education program. Trial registration Trial registration number: NCT03659032; registration date: September 1, 2018. Retrospectively registered.

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Positional posterior plagiocephaly: a single-center review

Cited by 8 publications

References 15 publications

Pediatric cranial deformations: demographic associations

Pediatric cranial deformations: demographic associations

Efficacy of Pediatric Integrative Manual Therapy in Positional Plagiocephaly: A Randomized Controlled Trial.

Efficacy of pediatric integrative manual therapy in positional plagiocephaly: a randomized controlled trial

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