A Prospective Study of Cranial Deformity and Delayed Development in Children

Abstract

Plagiocephaly, the most common form of cranial deformity, has become more prevalent in recent years. Many authors have described a number of sequelae of poorly defined etiologies, although several gaps exist in their real scope. This study aimed to analyze the effects of physiotherapy treatments and cranial orthoses on the psychomotor development of infants with cranial deformities, complemented by protocolized postural exercises applied by the family. This prospective study on different developmental areas included a sample of 48 breastfeeding infants aged 6 to 18 months who presented with plagiocephaly (flat head syndrome). The Brunet–Lézine scale was used to perform three tests for assessing the psychomotor development of infants, thus offering a measure for global development. The results suggest that plagiocephaly is a marker for the risk of delayed development, particularly in motor and language areas. This delayed development could be improved with physiotherapy and orthopedic treatment, complemented by interventions by the infants´ relatives.

Outcome Analysis of the Effects of Helmet Therapy in Infants with Brachycephaly

“…Secondly, it is likely that the medical complications of brachycephaly were not serious enough to endure the discomfort and annoyance of the treatment. Deformational plagiocephaly is considered to be a risk for developmental delays [32,33]; however, the harmful effects of brachycephaly are controversial [8,9]. Recently, deformational plagiocephaly has been regarded as a consequence of early developmental delays, rather than the cause of delayed development [8,34].…”

“…A recent study has also shown that brachycephaly is associated with lower cognitive and academic measures in adolescence [7]. The delays were explained with various mechanisms and these associations remain controversial [8][9][10][11]. Collett et al mentioned the mechanical mechanism in which a cranial deformity leads to the dysmorphology of brain [10], but some have described brain dysmorphology in infants with cranial deformity not being clearly associated with skull shape [8,12].…”

“…However, some found the reason for the delayed development of infants with cranial deformity to be environmental factors-restricted movement, sleep position, or the amount of 'tummy time' [8,10,13]. A recent study suggested that delayed development could be improved through physiotherapy and orthopedic treatment [9]. Ocular motion abnormalities and otitis media are known to be associated with cranial deformity [14,15].…”

Active Cervical Range of Motion in Babies with Positional Plagiocephaly: Analytical Cross-Sectional Study

“…The peak can be observed at four months, and percentages are low after 8 months. Many cases of PP improve over time, but scientific evidence suggests that conservative management strategies can safely and effectively minimize the degree of cranial asymmetry [ 9 , 10 , 11 , 12 ].…”

Infant Cranial Deformity: Cranial Helmet Therapy or Physiotherapy?

“…The literature reports long-term clinical repercussions arising from the most severe cranial deformities, though unrelated to brain functions, such as deformities affecting orthodontic health and temporomandibular joint syndrome [5]. Several studies have reported an association between the presence of plagiocephaly and the delays in cognitive, language and motor development, which can persist up to 36 months of age [6][7][8][9]. Their results emphasize two hypothesized and potentially interacting pathways: environmental positioning as the primary driver for motor delays and simultaneously for plagiocephaly or an underlying central nervous system dysfunction as a primary driver of motor and cognitive delays, with motor delays leading to limited mobility and plagiocephaly [6][7][8].…”