Congenital Muscular Torticollis, Plagiocephaly, Nonsynostotic, Plagiocephaly, Positional
Conditions
Keywords
Manual Therapy, Physical Therapy, Cranial Asymmetry, Preferential position of the head
Brief summary
This study evaluates the efficacy of Pediatric Integrative Manual Therapy in the treatment of positional plagiocephaly in infants. 25 participants will receive a protocol of Pediatric Integrative Manual Therapy and educational physiotherapy in combination, while the other 25 will receive a stretching protocol and educational physiotherapy
Detailed description
The Manual Therapy has shown efficacy in different pathologies in the adult but it is not know its utility in infants and children population, nor in specific pathologies as non synostotic plagiocephaly. In the conservative treatment of plagiocephaly the educational physiotherapy and the helmet therapy have the better level of evidence among other treatments. When babies present preferential position of the head or Congenital Muscular Torticollis, stretching has shown efficacy. A protocol of ten sessions of Pediatric Manual Therapy will be applied to infants with positional plagiocephaly in combination with educational physiotherapy. The protocol consists in soft cervical mobilisation, myofascial induction and the application of some pressures to the cranial bones to improve the asymmetry of the head. Educational therapy which consists in more tummy time stimulation, stimulation to the non preference position of the head and counter positioning. The control group will receive a protocol of stretching at home done by their parents and Educational therapy.
Interventions
PROCEDUREPediatric Integrative Manual Therapy and educational therapy
Pediatric Integrative Manual Therapy is a soft Orthopedic Manual Therapy approach por infants and children. It integrates joints soft mobilisation, myofascial release and neurodynamic mobilisation. Also the educational therapy.
PROCEDUREStretching and educational therapy
It is a protocol of stretching based on literature research. Also the educational therapy with counter positioning, stimulation in prone position, positional care, etc.
Sponsors
Universidad de Zaragoza
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
Double (Investigator, Outcomes Assessor) The assessors who receive participants and do the measurement are masked
Intervention model description
Parallel assignment
Eligibility
Sex/Gender
ALL
Age
0 Months to 12 Months
Healthy volunteers
No
Inclusion criteria
* Sign of positional plagiocephaly * Infants below 12 moths age
Exclusion criteria
* No neurological disorders * No infectious diseases * No respiratory diseases * No other treatments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Function Test | 4 weeks | Measured in lateral suspension giving a value of 0 to 5 according to the alignment of the head with the trunk |
| Right Oblique Cranial Vault Diameter | 4 weeks | Measured with caliper, is the distance from left external part of the orbit to the right lambdoid suture at the horizontal plane |
| Left Oblique Cranial Vault Diameter | 4 weeks | Measured with caliper, is the distance from right external part of the orbit to the left lambdoid suture at the horizontal plane |
| Active Cervical Rotation Range of movement | 4 weeks | Measured with photographs and digital angular analysis |
| Passive Cervical Rotation Range of movement | 4 weeks | Measured lying down with joint goniometer |
| Passive Cervical Lateral Flexion Range of movement | 4 weeks | Measured lying down with joint goniometer |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cranial length | 4 weeks and 10 weeks | Measured with calliper, is the distance from most anterior point in the frontal bone in the middle line to the most posterior point in the cranial vault on the horizontal plane in the middle line |
| Cranial wide | 4 weeks | Measured with calliper, is the distance between the two more lateral points in the vault, usually in the temporal or parietal bone. |
| Cranial maximal circumference | 4 weeks | Measured in cm with a measuring tape. |
| Alberta Infant Motor Scale | 10 weeks | Neuromotor scale for infants from 0 to 14 months. Maximum value 90th; minimum value 0th. Higher scores indicate a better motor and postural development. Values below 15th indicate risk of development delay. |
| Visual Analogical Scale about improvement in cervical movement after intervention | 10 weeks | Parents perception of changes in their baby. Minimum value -10; maximum value +10. Higher scores indicate a better perception of change in the cervical movement. |
| Visual Analogical Scale about improvement in cranial asymmetry after intervention | 10 weeks | Parents perception of changes in their baby. Minimum value -10; maximum value +10. Higher scores indicate a better perception of change in the head shape |
Countries
Spain
Contacts
Primary ContactIñaki Pastor Pons
Outcome results
None listed