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Significant Factors Influencing the Effectiveness of Cranial Remolding Orthoses in Infants With Deformational Plagiocephaly

Graham, Tiffany MSPO, CPO; Gilbert, Nicole MPO; Witthoff, Kirsten BSN, MPO; Gregory, Terran MPO; Walsh, Mary MPO

doi: 10.1097/SCS.0000000000005512
Original Article: PDF Only

Infants with deformational plagiocephaly may be indicated for a cranial remolding orthosis (CRO) depending on the severity of deformation. Studies have found torticollis and prematurity to be risk factors for the development of deformational plagiocephaly and indicate younger infants have faster and greater correction. However, clinical decisions about which infants should be recommended for CRO treatment differ among healthcare providers and insurance coverage criteria vary. In order to provide insight into treatment recommendations, this study aims to examine the influence of 4 specific factors on CRO treatment time and the infant's resultant posttreatment head shape. Results indicate that presenting age, presenting severity, and the presence of torticollis significantly influence treatment duration. Presenting age and severity were found to significantly influence final head shape. The presence of prematurity was not found to be significant when infants were categorized by their corrected postpartum ages.

Prosthetics-Orthotics Program, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, TX.

Address correspondence and reprint requests to Tiffany Graham, MSPO, CPO, 6011 Harry Hines Blvd Ste V5.400, Dallas, TX 75390-9091; E-mail:

Received 29 November, 2018

Accepted 27 February, 2019

Research reported in this paper was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award Number UL1TR001105. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

TG is a previous employee of Level 4 Prosthetics and Orthotics. She was not employed by Level 4 during the course of this study and Level 4 did not actively participate in this study's data collection or analysis.

The authors report no conflicts of interest.

An abstract of this work was presented at the 2018 American Orthotic & Prosthetic Association (AOPA) National Assembly in Vancouver, BC where it received the Howard R. Thranhardt Award, which included an honorarium.

© 2019 by Mutaz B. Habal, MD.