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Brent Gordon

Abstract

Objective: Deformational plagiocephaly (DP) is a common post-natal acquired condition that occurs as a result of persistent direct pressure on unilateral occipital structures. Various cognitive and motor developmental delays have been associated with DP and this study investigates the impact of chiropractic management on infants with DP.

Methods: Diagonal skull measurements were analysed from 23 infants determined to have mild (3-7%), moderate (7-12%) or severe (>12%) DP using the cranial vault asymmetry index (CVAI). Parents were offered chiropractic management alone or chiropractic management and a pressure reducing pillow.

Results: The average age at initial presentation was 12.5 weeks. The mean CVAI decreased during the first six weeks of treatment from 8.77% (SD 2.65%) to 5.60% (SD 2.95%) (D CVAI 3.17%) and to a further 4.60% (SD 2.84%) at final assessment at an average age of 29.8 weeks (D CVAI 4.18%). On average there was a 36.1% improvement in CVAI for the first six weeks of treatment and an overall 47.7% improvement in CVAI from initial presentation to final measurement following 6.9 visits on average. The 17 children who utilized pillows in conjunction with chiropractic treatment had their mean CVAI decrease from 8.81% (SD 2.41%) to 5.17% (SD 2.90%) (D CVAI 3.64%), whereas the six children who had chiropractic treatment alone had their mean CVAI decrease from 8.67% (SD 3.50%) to 2.99% (SD 2.12%) (D CVAI 5.68%), an overall improvement of 65.5%. This was statistically different (p=0.031).

Conclusion: Chiropractic management of DP shows objective improvements in infant skull shape. Chiropractic management with no ancillary pillow device offers greater improvement, likely because of increased ease of cervical rotation and better re-moulding from a firm mattress rather than a soft pillow. The broader implications on potential cognitive and motor development outcomes needs further investigation and collaboration. (Chiropr J Australia 2017;45:155-174)

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