Plagiocephaly
Positional plagiocephaly, otherwise known as “Flat Head Syndrome”, is a change in the normal shape of the head and affects approximately 20% of 2-month-old infants, with its prevalence increasing since the “Back to Sleep” campaign. The condition is typically diagnosed through clinical examination and physical assessment. A simple method to evaluate the severity of plagiocephaly involves using a diagonal caliper to measure the difference between diagonal lengths on each side of the head (and talk to Dr Christian about this – he *might* have a patent pending on a fancy new device to do this!).
Conservative Treatment Approaches
Conservative treatments for positional plagiocephaly include:
- Repositioning techniques
- Manual therapy
- Helmet therapy
These approaches are particularly effective when initiated early due to the plasticity of the infant’s skull and cranial sutures.
Cervical Range of Motion and Plagiocephaly
A study by Dr Christian and Braden Keil (2020) involving 150 infants under 12 months of age found a significant association between plagiocephaly and restrictions in cervical passive range of motion (PROM). The key findings from this study showed:
- 78.7% of infants had restrictions in cervical PROM
- 60.2% showed indications of plagiocephaly
- 92.2% of infants with plagiocephaly had restrictions in cervical PROM
The study also found a statistically significant association between restriction of the occipitoatlantal joint and contralateral deformational plagiocephaly.
What does this mean?
Conservative treatments, particularly when initiated early, show promise in managing positional plagiocephaly. Molding therapy appears to be more effective than repositioning alone. The strong association between cervical PROM restrictions and plagiocephaly suggests that addressing neck mobility issues could be an important component of treatment. However, more high-quality research, particularly randomized controlled trials, is needed to determine the most effective interventions and to evaluate the safety and efficacy of spinal manipulation for plagiocephaly in infants.
Bibliography
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206465/
[2] https://jamanetwork.com/journals/jamapediatrics/fullarticle/380008
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10378416/
[4] https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2020_013.pdf
[5] https://www.jpedhc.org/article/S0891-5245%2811%2900366-X/fulltext
[6] https://www.jccponline.com/plagiocephaly.html
[7] https://kingsparkchiropractic.com.au/2022/07/28/how-chiropractic-care-helps-plagiocephaly/
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762100/