KMID : 1161220240670010046
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Clinical and Experimental Pediatrics 2024 Volume.67 No. 1 p.46 ~ p.53
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Effectiveness of helmet therapy for infants with moderate to severe positional plagiocephaly
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Kim Jeong-Ho
Kim Ji-Na Chae Kyu-Young
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Abstract
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Background: The use of helmet treatment for positional plagiocephaly has increased recently; however, its effect is unknown in Korea.
Purpose: This study aimed to investigate the effectiveness of helmet therapy and identify its influencing factors.
Methods: Ninety pediatric patients diagnosed with moderate to severe positional plagiocephaly received helmet therapy. Severity of moderate to severe positional plagiocephaly was defined as cranial vault asymmetry (CVA) >10 mm or CVA index (CVAI) >6%. Patients were categorized by age, severity, and daily helmet wear. Multiple regression analysis controlled for factors like sex and prematurity. Treatment success was assessed by comparing pre/post-helmet theray CVA and CVAI, considering normalization or decrease to mild plagiocephaly (CVA ¡Â10 mm or CVAI ¡Â6%).
Results: A total of 90 participants were enrolled (mean age, 5.6¡¾1.6 months; male, 53 [58.9%]). The mean helmet therapy duration was 6.4¡¾2.7 months, while the mean daily wear time was 18.4¡¾2.7 hours. Among the 90 patients, 66 (73.3%) had moderate disease and 24 (26.7%) had severe disease. The mean CVA and CVAI decreased by 6.3¡¾2.7 mm and 4.3%¡¾1.8% after versus before treatment (P<0.001). Treatment was successful in 76 infants (84.4%). The most effective changes in CVA and CVAI were noted in those who began treatment before 9 months of age (6.2¡¾2.5 mm and 5.0%¡¾1.9%, P<0.001), had high compliance (6.2¡¾2.4 mm and 4.9%¡¾1.9%, P<0.001), and had high severity (8.0¡¾2.3 mm and 6.6%¡¾1.7%, P<0.001).
Conclusion: Starting helmet treatment before 9 months and wearing it over 15 hours daily yielded better outcomes.
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KEYWORD
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Positional plagiocephaly, Helmet therapy, Cranial vault asymmetry, Cranial vault asymmetry index
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