Date: October 2023.
Source: Journal of Rehabilitation and Assistive Technologies Engineering (JRATE), Vol. 10, No 1S (Supplement), pp. 6-7.
Objective: Traditionally, when an infant is treated for a deformational head shape (DHS), asymmetries between the left and right cranium are quantified by taking diagonal measurements along the greater equator of the skull, and asymmetry is expressed comparison of the diagonal length asymmetries. However, quantification via 2-dimensional measurements at a single level of the cranium might not always accurately portray a 3-dimensional change. 3-dimensional changes were examined in infants treated for DHS asymmetries to compare net quadrant growth during each of these treatment methods, as well as net asymmetry change seen posttreatment (natural growth).
Materials and Methods: Two-month old infants with DHS began repositioning therapy (RT) and received physical therapy if torticollis was present. For persistent cranial deformation, caregivers were given the option to begin treatment with a cranial remolding orthosis (CRO) at 4, 5, or 6 months of age. At 6 months of age, any infant who had not switched to CRO treatment was permanently assigned to RT. Infants received 3dMD scans at 2 months of age, at clinical resolution of their head shape, and at 12 months of age. If their head shape was not resolved by 12 months of age, they received only two 3dMD scans (at 2 and 12 months of age). Clinical resolution was based on measured cranial vault asymmetry index1 and a visual assessment by the treating orthotist. Consecutive scans were aligned based on 25 landmarks, anisotropically scaled, and analyzed using a MATLAB algorithm. A morphometric analysis quantified net 3-dimensional change of the head shape between two consecutive 3dMD scans. The cranium was then divided into quadrants. The percentage of net growth of flattened quadrants was found by dividing the difference between mean net growth of the flattened quadrant and the bossed quadrants, divided by the mean net growth of the bossed quadrants. A negative percentage indicated a worsening of the head shape (bossed quadrants growing more than flattened quad- rants) and a positive percentage indicated improvement. Excel was used to plot mean changes in cranial shape and the Kruskal- Wallis test was used to compare mean net percentage change short quadrants between groups.
Results: Twenty-six infants were enrolled and followed. Figure 1 shows morphometric changes for an infant who underwent RT, transitioned to a CRO until the head shape was resolved, and was followed through natural growth to 12 months of age.
Article: An examination of 3-dimensional change for infants with deformational plagiocephaly.
Authors: Tiffany Graham, MSPO C/LPO, FAAOP(D); Jijia Wang, PhD; Victoria Moses, MPO; Shea Briggs, MPO; Olivia Sheffer, MPO; Amy Payne MPO; Lindsay Pauline, MPO; Tristine Lam, MPO; Ashton Blasingim MPO; Cayman Holley, MPO; Tally Marlow, MPO; Rami Hallac, PhD. University of Texas Southwestern Medical Center, Dallas, Texas, USA.