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Head Shape Retention Following Helmet Therapy for Deformational Plagiocephaly

Naidoo, Sybill D. PhD, CPNP*; Skolnick, Gary B. BA*; Galli, Anthony D. Jr BOCO; Patel, Kamlesh B. MD, MSc*

doi: 10.1097/SCS.0000000000005618
Clinical Study: PDF Only

Background: The aim of the present study was to evaluate whether any change can be expected in the 6-month period after completing treatment with a molding helmet for deformational plagiocephaly. A retrospective review of helmeted patients from a deformational plagiocephaly clinic from May 2010 to June 2011.

Methods: A total of 71 individuals with 6-month follow-up after completion of molding helmet treatment were identified. About 51 males and 20 females ranged in age from 2 to 10 months at initial treatment. The main outcome measure was the amount of change in head shape in the 6-month period following molding helmet therapy.

Results: During the course of helmet treatment cephalic index and cranial vault asymmetry both decreased significantly (P < 0.001). Posthelmet follow-ups revealed a further decrease in cephalic index (P < 0.001). Although the cranial vault asymmetry decreased slightly between the final helmeting visit and the follow-up visit, this change was not statistically significant (P = 0.292). Controlling for other factors, continued normalization was not significantly related to helmeting duration.

Conclusion: Findings revealed both cephalic index and cranial vault asymmetry improved while in the helmet. During the 6 months following helmet treatment, cephalic index continued to improve; cranial vault asymmetry changed only insignificantly in this same period.

*Cleft Palate and Craniofacial Institute, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St Louis, MO

Orthotics & Prosthetics Lab, Inc, Webster Groves, MO.

Address correspondence and reprint requests to Sybill D. Naidoo, PhD, CPNP, 660 S Euclid, Campus Box 8238, St Louis, MO 63110; E-mail:

Received 4 March, 2019

Accepted 24 March, 2019

Dr Naidoo is a speaker for Hanger Clinic and Orthomerica. Dr Patel is a speaker for Hanger Clinic and a consultant for Stryker.

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

© 2019 by Mutaz B. Habal, MD.