A 10-Year Review of the Efficacy of Cranial Remolding Orthosis Treatment and Factors That Influence Outcomes for Infants with Isolated Deformational Plagiocephaly.

BACKGROUND/

OBJECTIVES

The purpose of this study was to examine the overall efficacy and treatment outcomes of CROs in the treatment of isolated deformational plagiocephaly and investigate the variables that influence treatment efficacy.

METHODS

This was a 10-year retrospective review of N = 27, 990 infants with Isolated Deformational Plagiocephaly (IDP) who completed Cranial Remolding Orthosis (CRO) treatment between 3 and 18 months of age.

RESULTS

There was a significant overall mean change in CVAI(S) of -3.42 ± 0.011 (p < 0.001), and a significant improvement in CVAI(S) in all age groups, even in older babies (i.e., >11 months). Up to 96% of infants aged 4-6 months at initiation of treatment achieved a "good" or "great" outcome rating, and up to 77.6% of infants over 11 months exited with a similar outcome. The following were identified as significant predictors of greater change in CVAI(S): (1) younger entry age (p < 0.001, β = 0.01), (2) larger initial CVAI(S) scores (p <0.001, β = -0.43), (3) left plagiocephaly (p < 0.001, β = -0.36), and (4) and the absence of torticollis (p < 0.001, β = -0.17).

CONCLUSIONS

CROs are an effective, research-supported treatment for IDP. Pediatric health care providers and parents should be aware of the efficacy of CRO therapy across age groups and severity ratings, the risk factors that may influence CRO outcomes, and the benefits of an early referral at a young age.