Objectives: Medical dictionaries and anthropologic sources de-fine brachycephaly as a cranial index (CI = width divided by length ×100%) greater than 81%.We examine the impact of supine sleeping on CI and compare...Objectives: Medical dictionaries and anthropologic sources de-fine brachycephaly as a cranial index (CI = width divided by length ×100%) greater than 81%.We examine the impact of supine sleeping on CI and compare orthotic treatment with repositioning.Study design: We compared the effect of repositioning versus helmet therapy on CI in 193 infants referred for abnormal head shape.Results: Eighty percent of the infants had a pretreatment CI >81%.Their initialmean CI atmean age 5.3 months was 89%, and after treatment, their mean CI was 87%(±2 SE = 0.9%) at mean age 9.0 months.For 92 infants with an initial CI at or above 90%, their initial mean CI of 96.1%was reduced to a mean of 91.9%.Conclusions: Post-treatment CI was 86%to 88%, CI in neonates delivered by cesarean section was 80%, and CI in supine-sleeping Asian children was 85%to 91%, versus 78%to 83%for prone-sleeping American children.Repositioning was less effective than cranial orthotic therapy in correcting severe brachycephaly.We recommend varying the head position when putting infants to sleep.展开更多
Objectives: We compare positioning with orthotic therapy in 298 consecutive infants referred for correction of head asymmetry.Study design: We evaluated 176 infants treated with repositioning, 159 treated with helmets...Objectives: We compare positioning with orthotic therapy in 298 consecutive infants referred for correction of head asymmetry.Study design: We evaluated 176 infants treated with repositioning, 159 treated with helmets, and 37 treated with initial repositioning followed by helmet therapywhen treatment failed.We compared reductions in diagonal difference (RDD)-between repositioning and cranial orthotic therapy.Helmets were routinely used for infants older than 6 months with DD >1 cm.Results: For infants treated with repositioning at a mean age of 4.8 months, the mean RDD was 0.55 cm (from an initial mean DD of 1.05 cm).For infants treated with cranial orthotics at a mean age of 6.6 months, the mean RDD was 0.71 cm (from an initial mean DD of 1.13 cm).Conclusions: Infants treated with orthotics were older and required a longer length of treatment (4.2 vs 3.5 months).Infants treated with orthosis had a mean final DD closer to the DD in unaffected infants (0.3 ±0.1 cm), orthotic therapy was more effective than repositioning (61%decrease versus 52%decrease in DD), and early orthosis was significantly more effective than later orthosis (65%decrease versus 51%decrease in DD).展开更多
文摘Objectives: Medical dictionaries and anthropologic sources de-fine brachycephaly as a cranial index (CI = width divided by length ×100%) greater than 81%.We examine the impact of supine sleeping on CI and compare orthotic treatment with repositioning.Study design: We compared the effect of repositioning versus helmet therapy on CI in 193 infants referred for abnormal head shape.Results: Eighty percent of the infants had a pretreatment CI >81%.Their initialmean CI atmean age 5.3 months was 89%, and after treatment, their mean CI was 87%(±2 SE = 0.9%) at mean age 9.0 months.For 92 infants with an initial CI at or above 90%, their initial mean CI of 96.1%was reduced to a mean of 91.9%.Conclusions: Post-treatment CI was 86%to 88%, CI in neonates delivered by cesarean section was 80%, and CI in supine-sleeping Asian children was 85%to 91%, versus 78%to 83%for prone-sleeping American children.Repositioning was less effective than cranial orthotic therapy in correcting severe brachycephaly.We recommend varying the head position when putting infants to sleep.
文摘Objectives: We compare positioning with orthotic therapy in 298 consecutive infants referred for correction of head asymmetry.Study design: We evaluated 176 infants treated with repositioning, 159 treated with helmets, and 37 treated with initial repositioning followed by helmet therapywhen treatment failed.We compared reductions in diagonal difference (RDD)-between repositioning and cranial orthotic therapy.Helmets were routinely used for infants older than 6 months with DD >1 cm.Results: For infants treated with repositioning at a mean age of 4.8 months, the mean RDD was 0.55 cm (from an initial mean DD of 1.05 cm).For infants treated with cranial orthotics at a mean age of 6.6 months, the mean RDD was 0.71 cm (from an initial mean DD of 1.13 cm).Conclusions: Infants treated with orthotics were older and required a longer length of treatment (4.2 vs 3.5 months).Infants treated with orthosis had a mean final DD closer to the DD in unaffected infants (0.3 ±0.1 cm), orthotic therapy was more effective than repositioning (61%decrease versus 52%decrease in DD), and early orthosis was significantly more effective than later orthosis (65%decrease versus 51%decrease in DD).
