Research and reports

Here are some links to some research and reports concerning plagiocepahly, brachycephaly, helmet use, repositioning, torticollis, etc. Some of the links are just to the abstracts, and unfortunately, in these cases, we cannot publish the full research because of copyright protection. If you have any links to add, please email the managers.


Risk Factors for Deformational Plagiocephaly at Birth and at 7 Weeks of Age: A Prospective Cohort Study
Leo A. van Vlimmeren, PT, PCS, BSc, <NOBR>Yolanda van der Graaf, MD, PhD</NOBR>, <NOBR>Magda M. Boere-Boonekamp, MD, PhD</NOBR>, <NOBR>Monique P. L'Hoir, PhD</NOBR>, <NOBR>Paul J.M. Helders, PT, PCS, MSc, PhD</NOBR> and <NOBR>Raoul H.H. Engelbert, PT, PCS, PhD
PEDIATRICS Vol. 119 No. 2 February 2007, pp. e408-e418 (doi:10.1542/peds.2006-2012)</NOBR>
http://pediatrics.aappublications.org/cgi/content/full/119/2/e408?rss=1
This Dutch study concludes that there are different risk factors for positional plagio at birth and at 7 weeks, namely:
- at birth:- being male, being first-born and having brachycephaly (a short head I assume, as opposed to positional flattening)
- at 7 weeks there are more risk factors:-  being male, being first-born, positional preference when sleeping, head to the same side on chest of drawers [changing table?], only bottle feeding, positioning to the same side during bottle feeding,doing tummy time when awake less than 3 times per day, and slow achievement of physical milestones. It specifically concludes also that there is no significant link between back sleeping and positional plagiocephaly. Additionally, there were no significant differences between children with and without plagio according to various aspects of the birth itself - e.g. presentation (breech, LOP, ROP, etc); mode of delivery (natural, forceps, ventouse, caesarian, etc.); or length of labour.

Plagiocephaly and Brachycephaly in the First Two Years of Life: A Prospective Cohort Study
Lynne Hutchison MD et al.
PEDIATRICS Vol. 114 No. 4 October 2004, pp. 970-980 (doi:10.1542/peds.2003-0668-F)
http://pediatrics.aappublications.org/cgi/content/full/114/4/970
This research article from New Zealand, published in 2004, is often misquoted as ‘evidence’ that plagiocephaly resolves on its own, because most people simply read the abstract and repeat the authors’ conclusions without calculating the data for themselves. To read a review of this research, by Cranial Technologies' Tim Littlefield, that better explains the results, please click here.

Neurodevelopmental delays in children with deformational plagiocephaly
Plastic & Reconstructive Surgery. 117(1):207-218, January 2006
Kordestani, Rouzbeh K. M.D., M.P.H.; Patel, Shaurin M.D.; Bard, David E. M.S.; Gurwitch, Robin Ph.D.; Panchal, Jayesh M.D., M.B.A.
http://www.plasreconsurg.com/pt/re/prs/abstract.00006534-200601000-00032.htm;jsessionid=Fp2FF04Wpff1FT2y2pl1F2NspbQTWpmTNTq1lQM1sQLcgPpGLt6b!1513079044!-949856145!8091!-1

The 'Epidemic' of Deformational Plagiocephaly and the American Academy of Pediatrics' Response
WENDY S. BIGGS, MD
http://www.oandp.org/jpo/library/2004_04S_005.asp

Visual Field Defects in Deformational Posterior Plagiocephaly
Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 9, Issue 3, Pages 274-278R.
Siatkowski, A. Fortney, S. Nazir, S. Cannon, J. Panchal, P. Francel, W. Feuer, W. Ahmad

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15956949&query_hl=1  

This study concludes that plagiocephaly is connected with abnormal visual field constriction, such as with astigmatism. 35% of the plagio babies they looked at compared with normal cases had abnormal visual field constriction. There was no link between the severity of the plagio and the severity of the visual field constriction, i.e. even milder plagio could still result in abnormal findings.

Diagnosis and Management of Positional Head Deformity
WENDY S. BIGGS, MD, University of Michigan Medical School
http://www.aafp.org/afp/20030501/1953.html

Prevention and Management of Positional Skull Deformities in Infants
PEDIATRICS Vol. 112 No. 1 July 2003, pp. 199-202
http://pediatrics.aappublications.org/cgi/content/full/112/1/199

Craniofacial Deformity in Patients with Untreated Congenital Muscular Torticolls: An Assessment from Three-Dimensional Computed Tomography Imaging
http://www.thefilyaws.com/plagio/cti1196.pdf

Dynamic orthotic cranioplasty: treatment of the older infant.  Report of four cases.
TIMOTHY R. LITTLEFIELD, M.S., JEANNE K. POMATTO, B.O.C., AND KEVIN M. KELLY, PH.D.
http://www.aans.org/education/journal/neurosurgical/sep00/9-3-5.pdf

Determinants of Nonsynostotic Plagiocephaly: A Case-Control Study
http://pediatrics.aappublications.org/cgi/content/full/112/4/e316

Diagnosis and Management of Positional Head Deformity
http://www.aafp.org/afp/20030501/1953.html

Long-Term Developmental Outcomes in Patients With Deformational Plagiocephaly
http://pediatrics.aappublications.org/cgi/content/full/105/2/e26

Cranial Growth is Unrestricted during DOC treatment of Plagiocephaly
http://www.plagiocephaly.org/resources/pdf/iciscs8.PDF

Helmet Versus Non-helmet Treatment in Nonsynostotic Positional Posterior Plagiocephaly
http://www.jcraniofacialsurgery.com/pt/re/jcransurg/fulltext.00001665-200101000-00018.htm;jsessionid=CW3vMnQzrMDw123E8q4WnIA8r2CQ28B7IJCq0fPSu9LEMFAOm3Jh!2131737664!-949856031!9001!-1

Objective Outcome Analysis of Soft Shell Helmet Therapy in the Treatment of Deformational Plagiocephaly
http://www.jcraniofacialsurgery.com/pt/re/jcransurg/abstract.00001665-200407000-00022.htm;jsessionid=C5e7f83Bqo0aaWdYgMQ8DUgUG328L1UrHQWt3ybkrfwunZDpJFx5!-644112288!-949856032!9001!-1?index=1&results=1&count=10&searchid=1&nav=search&database=lwwovft

Molding Helmet Therapy in the Treatment of Brachycephaly and Plagiocephaly
http://www.jcraniofacialsurgery.com/pt/re/jcransurg/abstract.00001665-200401000-00031.htm;jsessionid=C5e7f83Bqo0aaWdYgMQ8DUgUG328L1UrHQWt3ybkrfwunZDpJFx5!-644112288!-949856032!9001!-1?index=1&results=1&count=10&searchid=1&nav=search&database=lwwovft

Active Counterpositioning or Orthotic Device to Treat Positional Plagiocephaly?
Basically this report says that repositioning is as effective as helmet therapy, but takes about three times as long.
http://www.jcraniofacialsurgery.com/pt/re/jcransurg/abstract.00001665-200107000-00003.htm;jsessionid=C5e7f83Bqo0aaWdYgMQ8DUgUG328L1UrHQWt3ybkrfwunZDpJFx5!-644112288!-949856032!9001!-1?index=1&results=1&count=10&searchid=1&nav=search&database=lwwovft

Plagiocephaly and head binding
S J Bridges, T L Chambers and I K Pople
http://adc.bmjjournals.com/cgi/content/full/86/3/144
This study concludes that cranial remoulding orthoses do not improve plagiocephaly. One of the authors, Ian Pople, has now distanced himself from this report.