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Roland H, Brown A, Rousselot A, Freeman N, Wieting JM, Bergman S, Mondal D. Osteopathic Manipulative Treatment Decreases Hospital Stay and Healthcare Cost in the Neonatal Intensive Care Unit. MEDICINES (BASEL, SWITZERLAND) 2022; 9:49. [PMID: 36286582 PMCID: PMC9607199 DOI: 10.3390/medicines9100049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients' recovery time and the financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented in this article that demonstrate infants treated with OMT recover faster, are discharged earlier, and have lower healthcare costs than their non-OMT-treated counterparts. Data clearly show that adjunctive OMT facilitates feeding coordination in newborns, such as latching, suckling, swallowing, and breathing, and increases long-term weight gain and maintenance, which reduces hospital length of stay (LOS). Osteopathic techniques, such as soft tissue manipulation, balanced ligamentous tension, myofascial release, and osteopathic cranial manipulation (OCM), can reduce regurgitation, vomiting, milky bilious, or bloody discharge and decrease the need for constipation treatment. OMT can also be effective in reducing the complications of pneumonia in premature babies. Studies show the use of OCM and lymphatic pump technique (LPT) reduces the occurrence of both aspiration and environmentally acquired pneumonia, resulting in significantly lower morbidity and mortality in infants. Based on published findings, it is determined that OMT is clinically effective, cost efficient, a less invasive alternative to surgery, and a less toxic choice to pharmacologic drugs. Therefore, routine incorporation of OMT in the NICU can be of great benefit in infants with multiple disorders. Future OMT research should aim to initiate clinical trial designs that include randomized controlled trials with larger cohorts of infants admitted to the NICU. Furthermore, a streamlined and concerted effort to elucidate the underlying molecular mechanisms associated with the beneficial effects of OMT will aid in understanding the significant value of incorporating OMT into optimal patient care.
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Affiliation(s)
- Hannah Roland
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
| | - Amanda Brown
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
| | - Amy Rousselot
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
| | - Natalie Freeman
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
| | - J. Michael Wieting
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, USA
| | - Stephen Bergman
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, USA
| | - Debasis Mondal
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
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Billi M, Greco A, Colonneli P, Volpi G, Valente D, Galeoto G. The functional manual therapy intervention in infants with non-synostotic plagiocephaly: a pilot study. Minerva Pediatr (Torino) 2022; 74:294-300. [DOI: 10.23736/s2724-5276.17.04838-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pastor-Pons I, Lucha-López MO, Barrau-Lalmolda M, Rodes-Pastor I, Rodríguez-Fernández ÁL, Hidalgo-García C, Tricás-Moreno JM. Efficacy of pediatric integrative manual therapy in positional plagiocephaly: a randomized controlled trial. Ital J Pediatr 2021; 47:132. [PMID: 34090515 PMCID: PMC8180102 DOI: 10.1186/s13052-021-01079-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/17/2021] [Indexed: 11/17/2022] Open
Abstract
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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Affiliation(s)
- Iñaki Pastor-Pons
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009 Zaragoza, Spain
- Instituto de Terapias Integrativas, Constitución 29 Dplo, 50001 Zaragoza, Spain
| | - María Orosia Lucha-López
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009 Zaragoza, Spain
| | | | - Iñaki Rodes-Pastor
- Instituto de Terapias Integrativas, Constitución 29 Dplo, 50001 Zaragoza, Spain
| | - Ángel Luis Rodríguez-Fernández
- Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo CEU, Urbanización Montepríncipe, 28925, Alcorcón, Madrid, Spain
| | - César Hidalgo-García
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009 Zaragoza, Spain
| | - Jose Miguel Tricás-Moreno
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Domingo Miral, s/n, 50009 Zaragoza, Spain
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Mills MV. The use of osteopathic manipulative treatment in the newborn nursery and its effect on health in the first six months of life: A retrospective observational case-control study. Complement Ther Clin Pract 2021; 43:101357. [PMID: 33714862 DOI: 10.1016/j.ctcp.2021.101357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Limitations of traditional medicine and rising interest in complementary medicine call for a closer look at the potential relevance of manual medicine, specifically osteopathic manipulative treatment (OMT) in children. OBJECTIVE To conduct a retrospective observational pilot study of babies who received OMT in the newborn nursery compared to those who did not, by quantifying their outpatient health issues in the first 6 months of life, and to determine the feasibility of further definitive randomized controlled trials of a similar nature. DESIGN Retrospective chart review of the first 6 months of life from pediatric clinic records of 58 case-matched pairs of children, half of whom received OMT as part of their routine newborn care by virtue of their physician "call" assignment to the author. The sample from which the case-matched control group was chosen were babies who had received routine allopathic newborn care without OMT. Both groups received their pediatric care in the same academic ambulatory clinic and received no further OMT. METHODS Outpatient paper chart review consisted of tabulation by points of the following variables: mention of spitting/vomiting, gassiness, food intolerance, irritability/sleeplessness, colic suggested or diagnosed, episodes of otitis media, frequency of antibiotics given, frequency of upper respiratory infections, frequency of lower respiratory problems, diarrhea, and rashes, separated by month of visit in which the variable was reported. RESULTS Exploratory analysis by Pearson Chi-square yielded a few statistically significant differences between the 2 groups, in favor of the OMT-treated group, including Month 2 food intolerance (Χ21 = 4.14, P = .04), Month 3 colic suggested (Χ21 = 4.14, P = .04), Month 5 spitting/vomiting (Χ21 = 8.59, P = .003), and Month 5 antibiotic usage (Χ21 = 6.33, P = .012). CONCLUSIONS Findings point to the need for further research in this area based on the suggestion that OMT given to a newborn can positively affect that baby's short-term and quite possibly long-term health, specifically related to GI complaints and irritability. Other studies would benefit from a variety of methodologic changes, including correlation of timing of administration of OMT with possible symptoms and changes in those symptoms over longer periods of observation, as well as correlation of anatomic osteopathic findings with specific symptoms.
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Affiliation(s)
- Miriam V Mills
- Department of Osteopathic Manual Medicine, Oklahoma State University Center for Health Sciences, 1111 West 17th Street, Tulsa, OK, 74107, USA.
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Filisetti M, Cattarelli D, Bonomi S. Positional plagiocephaly from structure to function: Clinical experience of the service of pediatric osteopathy in Italy. Early Hum Dev 2020; 146:105028. [PMID: 32450443 DOI: 10.1016/j.earlhumdev.2020.105028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Aim of the study is to evaluate disorders related to positional plagiocephaly and introduce a new model of early intervention based on the osteopathic integrated approach. METHODS We review clinical experience of the "Program for Neurodevelopmental Follow-up and Pediatric Osteopathy", a service dedicated to newborns at risk for developmental disorders. RESULTS We present clinical data of 310 newborns followed during first years of life. Data analysis examines perinatal history, general features and disorders that could be related to plagiocephaly. CONCLUSIONS The experience confirms that plagiocephaly is not only a problem regarding the shape of the head, it involves the functions. In our Service most babies (81%) with positional plagiocephaly showed isolated or associated disorders that had an impact on growth, behavior and development. The early intervention based on the osteopathic integrated approach is addressed not only to the cranial shape but consider the baby as a whole, and the environment where he lives.
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Affiliation(s)
| | | | - Stefano Bonomi
- Desenzano del Garda Hospital (ASST del Garda, Bs), Italy; Osteopathic Center for Children Italy (Lonato del Garda, Bs), Italy
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Yang W, Chen J, Shen W, Wang C, Wu Z, Chang Q, Li W, Lv K, Pan Q, Li H, Ha D, Zhang Y. Prevalence of positional skull deformities in 530 premature infants with a corrected age of up to 6 months: a multicenter study. BMC Pediatr 2019; 19:520. [PMID: 31888564 PMCID: PMC6937833 DOI: 10.1186/s12887-019-1864-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/28/2019] [Indexed: 11/21/2022] Open
Abstract
Background Positional deformities (PD) are common during early infancy. Severe cases may result in facial abnormalities and be associated with delayed neurological development in infants. The earlier the detection of PD, the better the intervention effect and the lower the cost of treatment. Currently, there are many studies on PD in Europe and the United States. However, in China, there is little data on the basic metrics and incidence of PD. Premature infants have a high risk of PD. However, there are few studies on PD in premature infants globally, and none in Asia. This study aimed to investigate PD and its characteristics inpremature infants to help its early detection and intervention and thus improve the quality of life for premature infants. Methods We analyzed 530 preterm infants who visited the outpatient departments at Xinqiao Hospital of Army Medical University and Maternal and Child Health Care Hospitals of Wanzhou and Yongchuan Districts in Chongqing from September 1, 2016, to August 31, 2017. The head shape data measured by a simple manual method were recorded. The diagonal difference (DD) between the transcranial diagonals and the cranial index (CI) was calculated. PD and its incidences indifferent gestational ages and corrected age groups were analyzed. Results According to previously defined international diagnostic criteria, the incidence of plagiocephaly, brachycephaly, and dolichocephaly were 51.1, 85.1, and 3.0% respectively, and those of right and left plagiocephalywere69.4 and 30.6%, respectively. The incidence of PD was highest among infants with a gestational age of < 32 weeks and decreased as the gestational age increased. As the corrected age (CA) increased, the incidence of plagiocephaly and dolichocephaly decreased, and the incidence of brachycephaly increased. Conclusions PD incidence is high among preterm infants. As gestational age decreased, PD incidence and severity increased. Therefore, healthcare providers should implement early PD detection and intervention to prevent the adverse outcomes. The extremely high incidence of brachycephaly and extremely low incidence of dolichocephaly in this study are likely to be due to the variance of cranial metrics caused by cultural differences. The Chinese standards for infant cranial measurements must be established.
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Affiliation(s)
- Wang Yang
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Jianping Chen
- Department of Child Health Care, Yongchuan Maternal and Child Health Care Hospital of Chongqing, Chongqing, 402160, China
| | - Wenzhi Shen
- Department of Child Health Care, Wanzhou Maternal and Child Health Care Hospital of Chongqing, Chongqing, 404000, China
| | - Chengju Wang
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Zhifeng Wu
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Qing Chang
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Wenzao Li
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Kuilin Lv
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Qiuming Pan
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Hongxia Li
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Duyao Ha
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China
| | - Yuping Zhang
- Department of Pediatrics, the Second Affiliate Hospital of Army Medical University, No. 83 Xinqiao Street, Chongqing, 400037, China.
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武 燕, 吴 至, 张 雨, 赵 聪, 余 秀, 杨 望, 陈 再, 潘 秋. [Efficacy of sleep position correction for treating infants with positional plagiocephaly]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:688-692. [PMID: 28606238 PMCID: PMC7390297 DOI: 10.7499/j.issn.1008-8830.2017.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the efficacy of 2-month course of sleeping position correction in the treatment of positional plagiocephaly in infants aged <8 months. METHODS A total of 73 infants with positional plagiocephaly between January 2015 and June 2016 were divided into treatment group (n=46) and control group (n=27) according to parents' wishes. The treatment group received sleeping position correction, while the control group received sleep curve mattress. The oblique diameters A and B in the two groups were measured and the cranial vault asymmetry (CVA) was calculated before and after treatment. The severity of positional plagiocephaly based on CVA was compared between the two groups before and after treatment. The Gesell Developmental Scale was used to determine the developmental quotients (DQs) in the motor, adaptive, language, and social domains in the two groups before and after treatment. RESULTS Before treatment, there were no significant differences in oblique diameters A and B, CVA, and DQs in the four specific domains between the two groups (P>0.05). After 2 months of treatment, the treatment group had a significantly greater oblique diameter B and a significantly smaller CVA than the control group (P<0.05); there were no significant differences in DQs in the four specific domains between the two groups (P>0.05). After treatment, both groups had significant improvements in oblique diameters A and B, CVA, and DQs in the motor and adaptive domains (P<0.01); moreover, the treatment group showed a significant improvement in the DQs in the social domain (P<0.01). There was no significant difference in the severity of positional plagiocephaly between the two groups before and after treatment (P>0.05). CONCLUSIONS For infants with positional plagiocephaly, sleeping position correction has better efficacy and is more convenient and economical than the sleep curve mattress, so it holds promise for clinical application.
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Affiliation(s)
- 燕 武
- />第三军医大学新桥医院儿科, 重庆 400037Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - 至凤 吴
- />第三军医大学新桥医院儿科, 重庆 400037Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - 雨平 张
- />第三军医大学新桥医院儿科, 重庆 400037Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - 聪敏 赵
- />第三军医大学新桥医院儿科, 重庆 400037Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - 秀梅 余
- />第三军医大学新桥医院儿科, 重庆 400037Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - 望 杨
- />第三军医大学新桥医院儿科, 重庆 400037Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - 再新 陈
- />第三军医大学新桥医院儿科, 重庆 400037Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - 秋名 潘
- />第三军医大学新桥医院儿科, 重庆 400037Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
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De Bock F, Braun V, Renz-Polster H. Deformational plagiocephaly in normal infants: a systematic review of causes and hypotheses. Arch Dis Child 2017; 102:535-542. [PMID: 28104626 DOI: 10.1136/archdischild-2016-312018] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Deformational plagiocephaly (DP) is one of the most prevalent abnormal findings in infants and a frequent reason for parents to seek paediatric advice. OBJECTIVE To systematically review the literature and identify evidence and hypotheses on the aetiology and determinants of DP in otherwise healthy infants. DESIGN Systematic keyword search in all major biomedical databases to identify peer-reviewed publications reporting (a) empirical research or (b) hypotheses on the aetiology of DP in healthy, term infants. 3150 studies published between 1985 and 2016 and containing relevant keywords were screened. In a two-pronged approach, results were summarised separately for the body of empirical work (22 studies) and the body of hypotheses (110 articles). REVIEW FINDINGS Only a few empirical studies have examined risk factors in non-selected patient populations on a higher grade methodological level. The most commonly reported risk factors were: male gender, supine sleep position, limited neck rotation or preference in head position, first-born child, lower level of activity and lack of tummy time. Agreement between empirical studies was poor for most exposures, including supine sleep position, tummy time and use of car seats. The articles reporting hypotheses on the aetiology of DP cover a wide field of environmental and biological factors, but include little suggestions as to the potential influence of the everyday care environment of the baby. CONCLUSIONS AND RELEVANCE The evidence on the aetiology of DP is fragmentary and heterogeneous. In addition, factors possibly relevant to the development of DP have not been appreciated in the scientific discussion.
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Affiliation(s)
- Freia De Bock
- Mannheim Institute of Public Health, Social and Preventive Medicine, University Medicine Mannheim, Heidelberg University, Mannheim, Germany.,Centre for Child Neurology, Frankfurt am., Germany
| | - Volker Braun
- University Library, University Medicine Mannheim, Medical faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Herbert Renz-Polster
- Mannheim Institute of Public Health, Social and Preventive Medicine, University Medicine Mannheim, Heidelberg University, Mannheim, Germany
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van Vlimmeren LA, Engelbert RHH, Pelsma M, Groenewoud HMM, Boere-Boonekamp MM, der Sanden MWGNV. The course of skull deformation from birth to 5 years of age: a prospective cohort study. Eur J Pediatr 2017; 176:11-21. [PMID: 27815732 PMCID: PMC5219011 DOI: 10.1007/s00431-016-2800-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 08/17/2016] [Accepted: 10/18/2016] [Indexed: 12/04/2022]
Abstract
In a continuation of a prospective longitudinal cohort study in a healthy population on the course of skull shape from birth to 24 months, at 5 years of age, 248 children participated in a follow-up assessment using plagiocephalometry (ODDI-oblique diameter difference index, CPI-cranio proportional index). Data from the original study sampled at birth, 7 weeks, 6, 12, and 24 months were used in two linear mixed models. MAIN FINDINGS (1) if deformational plagiocephaly (ODDI <104%) and/or positional preference at 7 weeks of age are absent, normal skull shape can be predicted at 5 years of age; (2) if positional preference occurs, ODDI is the highest at 7 weeks and decreases to a stable lowest value at 2 and 5 years of age; and (3) regarding brachycephaly, all children showed the highest CPI at 6 months of age with a gradual decrease over time. CONCLUSION The course of skull deformation is favourable in most of the children in The Netherlands; at 5 years of age, brachycephaly is within the normal range for all children, whereas the severity of plagiocephaly is within the normal range in 80%, within the mild range in 19%, and within the moderate/severe range in 1%. Medical consumption may be reduced by providing early tailored counselling. What is Known: • Skull deformation prevalence increased after recommendations against Sudden Infant Death Syndrome, little is known about the longitudinal course. • Paediatric physical therapy intervention between 2 and 6 months of age reduces deformational plagiocephaly at 6 and 12 months of age. What is New: • The course of skull deformation is favourable in most of the children in The Netherlands; at 5 years of age, deformational brachycephaly is within the normal range for all children, whereas the severity of deformational plagiocephaly is within the normal range in 80%, within the mild range in 19%, and within the moderate to severe range in only 1%. • Paediatric physical therapy intervention does not influence the long-term outcome; it only influences the earlier decrease of the severity of deformational plagiocephaly.
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Affiliation(s)
- Leo A van Vlimmeren
- Department of Rehabilitation, Paediatric Physical Therapy, Radboud university medical center, P.O. 9101, 6500 HB Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, IQ healthcare, Radboud university medical center, P.O. 9101, 6500 HB Nijmegen, The Netherlands
| | - Raoul HH Engelbert
- ACHIEVE, Center of Applied Research, Faculty of Health, University of Applied Sciences, Tafelbergweg 51, 1000 CN Amsterdam, The Netherlands
- Academic Medical Center, Department of Rehabilitation, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Maaike Pelsma
- Department of Rehabilitation, Paediatric Physical Therapy, Radboud university medical center, P.O. 9101, 6500 HB Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, IQ healthcare, Radboud university medical center, P.O. 9101, 6500 HB Nijmegen, The Netherlands
| | - Hans MM Groenewoud
- Department for Health Evidence, Radboud university medical center, P.O. 9101, 6500 HB Nijmegen, The Netherlands
| | - Magda M Boere-Boonekamp
- Department Health Technology and Services Research, Institute for Governance Studies, University of Twente, P.O. 217, 7500 AE Enschede, The Netherlands
| | - Maria WG Nijhuis-van der Sanden
- Department of Rehabilitation, Paediatric Physical Therapy, Radboud university medical center, P.O. 9101, 6500 HB Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, IQ healthcare, Radboud university medical center, P.O. 9101, 6500 HB Nijmegen, The Netherlands
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Effects of manual therapy on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly: a randomised controlled pilot study. Childs Nerv Syst 2016; 32:2211-2217. [PMID: 27465676 DOI: 10.1007/s00381-016-3200-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/19/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Despite growing evidence regarding nonsynostotic plagiocephaly and their repercussions on motor development, there is little evidence to support the use of manual therapy as an adjuvant option. The aim of this study was to evaluate the effects of a therapeutic approach based on manual therapy as an adjuvant option on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly. METHODS This is a randomised controlled pilot study. The study was conducted at a university hospital. Forty-six infants with severe nonsynostotic plagiocephaly (types 4-5 of the Argenta scale) referred to the Early Care and Monitoring Unit were randomly allocated to a control group receiving standard treatment (repositioning and an orthotic helmet) or to an experimental group treated with manual therapy added to standard treatment. Infants were discharged when the correction of the asymmetry was optimal taken into account the previous clinical characteristics. The outcome measures were treatment duration and motor development assessed with the Alberta Infant Motor Scale (AIMS) at baseline and at discharge. RESULTS Asymmetry after the treatment was minimal (type 0 or 1 according to the Argenta scale) in both groups. A comparative analysis showed that treatment duration was significantly shorter (p < 0.001) in the experimental group (109.84 ± 14.45 days) compared to the control group (148.65 ± 11.53 days). The motor behaviour was normal (scores above the 16th percentile of the AIMS) in all the infants after the treatment. CONCLUSIONS Manual therapy added to standard treatment reduces the treatment duration in infants with severe nonsynostotic plagiocephaly.
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Morin C, Dorion D, Moutquin JM, Levasseur M. Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study. BMC Pediatr 2012; 12:181. [PMID: 23167940 PMCID: PMC3529688 DOI: 10.1186/1471-2431-12-181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 11/18/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eustachian tube (ET) dysfunction plays an important role in the pathogenesis of acute otitis media (AOM). Unfortunately, there is a lack of knowledge about the exact role of the ET's bony support, the temporal bone, on occurrence of AOM. This study investigates whether severe suture restriction of the temporal bone is a risk factor for development of AOM in young children. METHODS Using a prospective cohort design, 64 children aged 6 to 18 months without prior history of AOM were followed during the cold season (September 2009 to April 2010). Temporal bone status (categorized as with or without severe suture restriction) was evaluated using palpation and a cranial bone mobility test. Information about potential baseline confounders and risk factors for AOM (gender, age, birth weight, gestational age, use of pacifier, daycare attendance, presence of siblings, low socioeconomic status, breastfeeding ≥ 6 months, parental smoking and history of upper respiratory tract infection) were also collected. Occurrence of AOM diagnosed by physicians blinded to temporal bone status was the main outcome. Data were analyzed using hierarchical linear and nonlinear (multilevel) models. RESULTS Severe suture restriction of the temporal bone was identified in 23 children (35.9%). At least one AOM episode was diagnosed in 14 (48.3%) of the ears associated with temporal bones previously identified as having severe suture restriction and in 28 (28.3%) of those without severe suture restriction. Higher risk for AOM was explained by severe suture restriction of the temporal bone (adjusted relative risk (RR), 2.26, 95% CI 1.43 to 2.91, p<.01), pacifier use (RR, 2.59, 95% CI 1.51 to 3.22, p<.01) and younger age (RR, 0.22, 95% CI 0.10 to 0.52, p=.001). CONCLUSIONS The study results indicate that severe suture restriction of the temporal bone is a risk factor for AOM in young children. Subsequent intervention studies are needed to determine if this mechanical risk factor can be modified in young children.
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Affiliation(s)
- Chantal Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC J1H 5N4, Canada
| | - Dominique Dorion
- Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Jean-Marie Moutquin
- Department of Obstetrics-Gynecology, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC, J1H 5N4, Canada
- National Institute of Excellence in Health and Social Services, 2021, Avenue Union, bureau 10.082, Montréal, QC, H3A 2S9, Canada
| | - Mélanie Levasseur
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC J1H 5N4, Canada
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Lessard S, Gagnon I, Trottier N. Exploring the impact of osteopathic treatment on cranial asymmetries associated with nonsynostotic plagiocephaly in infants. Complement Ther Clin Pract 2011; 17:193-8. [PMID: 21982132 DOI: 10.1016/j.ctcp.2011.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To document the evolution of cranial asymmetries in infants with signs of nonsynostotic occipital plagiocephaly (NSOP) who were to undergo a course of four osteopathic treatments (in addition to the standard positioning recommendations) as well as to determine the feasibility of using this methodology to conduct a randomized clinical trial investigating the impact of osteopathic intervention for infants with NSOP. DESIGN Pilot clinical standardization project using pre-post design in which 12 infants participated. Ten infants presented an initial Oblique Diameter Difference Index (ODDI) over 104% and five of them had an initial moderate to severe Cranial Vault Asymmetry (CVA) (over 12mm). INTERVENTIONS Infants received four osteopathic treatments at 2-week intervals. MAIN OUTCOME MEASURES Anthropometric, plagiocephalometric as well as qualitative measures were administered pre-intervention (T1), during the third treatment (T2) and two weeks after the fourth treatment (T3). RESULTS Participants showed a significant decrease in CVA (p=0.02), Skull Base Asymmetry (SBA) (p=0.01), Trans-Cranial Vault Asymmetry (TCVA) (p<0.003) between the first and third evaluations. CONCLUSIONS These clinical findings support the hypothesis that osteopathic treatments contribute to the improvement of cranial asymmetries in infants younger than 6.5 months old presenting with NSOP characteristics.
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Sándor GKB, McGuire TP, Ylikontiola LP, Serlo WS, Pirttiniemi PM. Management of facial asymmetry. Oral Maxillofac Surg Clin North Am 2008; 19:395-422, vi. [PMID: 18088893 DOI: 10.1016/j.coms.2007.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Asymmetries of the craniofacial region encompass a multitude of diverse and potentially complex abnormalities that may be the result of numerous causes. The expression and degree of asymmetry for a given condition, although a highly variable process, is the ultimate determinant of the nature of its treatment. This article highlights some of the key features and treatment strategies for various common facial asymmetries.
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Affiliation(s)
- George K B Sándor
- Graduate Program in Oral and Maxillofacial Surgery and Anesthesia, University of Toronto, Toronto, Ontario, Canada.
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Bialocerkowski AE, Vladusic SL, Wei Ng C. Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review. Dev Med Child Neurol 2008; 50:577-86. [PMID: 18754894 DOI: 10.1111/j.1469-8749.2008.03029.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This review synthesized current research evidence on the prevalence, risk factors, and natural history of positional plagiocephaly. Research published between 1985 and 2007 was sourced from 13 databases. Evidence was categorized according to a hierarchy and rated on a standardized critical appraisal tool. These evaluations were incorporated into a narrative synthesis of the main results. Eighteen studies met inclusion criteria (prevalence: n=3, risk factors: n=17, natural history: n=1). The methodological quality of studies was fair. The point prevalence of positional plagiocephaly appears to be age-dependent and may be as high as 22.1% at 7 weeks of age. Point prevalence tends to decrease with age and may be as low as 3.3% at 2 years. When compared with historical data, the prevalence of positional plagiocephaly appears to have remained stable over the last four decades. Assisted delivery, first born child, male sex, cumulative exposure to the supine position, and neck problems may increase the risk of positional plagiocephaly. To reduce the risk of positional placiocephaly, infants should experience a variety of positions, other than supine, while they are awake and supervised, and early treatment may be warranted for infants with neck problems and/or strong head preference.
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Les présentations cliniques. OSTÉOPATHIE PÉDIATRIQUE 2007. [PMCID: PMC7271215 DOI: 10.1016/b978-2-84299-917-9.50007-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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