Can CHiropractic Help Plagiocephaly (HEad Shape)

Deformational plagiocephaly or also known as positional plagiocephaly is a common disorder that can affect infants and children.   Head asymmetry is seen when the bone on the back of the head or the occipital bone is seen to be visibly flattened on one side.
 
Phagiocephaly can be caused by a range of underlying conditions including cervical spine joint dysfunction, infections, congenital conditions, neuromuscular conditions, trauma and genetic syndromes.  
Abnormal motion of the occiput and upper cervical vertebra was reported in 90% of children with plagiocephaly and a significant correlation was found between side of asymmetry and upper neck cervical spine joint dysfunction (Sergueef, Nelson, & Glonek, 2006).

A range of studies are now showing that deformational plagiocephaly is more than a “cosmetic” issue and has been associated with a range neurodevelopmental delays in infants to school aged children affecting the visual system, auditory system, motor development and cognitive development.

Chiropractic management of deformational plagiocephaly has been associated with management of normal head symmetry (Davies, 2002), although more research is always needed. Chiropractic treatment of cervical spine joint dysfunction is also important in restoring normal afferentation (sensory information) from the cervical spinal musculature, joints and other soft tissues that then may assist in improving long-term outcomes in gross and fine motor, cognitive and language development and proprioception (Palmgren, Sandström, Lundqvist, & Heikkilä, 2006) (Haavik & Murphy, 2012).
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Helmet therapy can assist cosmetic appearance in more severe cases of phagiocephaly from 6-7 months of age onwards and appear to produce faster correction than positional management alone. However the use of helmet therapy has been shown by a number of studies not to improve the neurodevelopmental outcomes. (Miller & Clarren, 2000) (Steinbok, Lam, Singh, Mortenson, & Singhal, 2007).
 
Early intervention has been associated with reduced treatment duration and improved cosmetic and neurodevelopmental outcomes (van Vlimmeren, et al., 2008) (Cabrera-Martos I. , et al., 2016). At Sprouting Health, infants with head asymmetry are comprehensively examined to determine the severity and likely cause of the phagiocephaly which allows us to determine the need for co-management with appropriate health professionals on a case-by-case basis to achieve the best results possible.  

REFERENCES

• Cabrera-Martos, I., Valenza, M. C., Valenza-Demet, G., Benitez-Feliponi, A., Robles-Vizcaino, C., & Ruiz-Extremera, A. (2016). Effects of manual therapy on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly: a randomised controlled pilot study. Child's Nervous System, 2211-2217.
• Davies, N. J. (2002, June). Chiropractic management of deformational plagiocephaly in infants: an alternative to device-dependant therapy. Chiropractic Journal of Australia, 32(2), 52-55.
• Haavik, H., & Murphy, B. (2012). The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. Journal of Electromyography and Kinesiology, 22(5), 768-776.
• Miller, R. I., & Clarren, S. K. (2000). Long-term developmental outcomes in patients with developmental plagiocephaly. Pediatrics, 105(2), e26(1-5).
• Palmgren, P. J., Sandström, P. J., Lundqvist, F. J., & Heikkilä, H. (2006). Improvement after chiropractic care in cervicocephalic kinesthetic sensibility and subjective pain intensity in patients with nontraumatic chronic neck pain. Journal of Manipulative and Physiological Therapeutics, 29(2), 100-106.
• Sergueef, N., Nelson, K., & Glonek, T. (2006). Palpatory diagnosis of plagiocephaly.
• Complementary Therapies in Clinical Practice, 101-110.
• Steinbok, P., Lam, D., Singh, S., Mortenson, P. A., & Singhal, A. (2007). Long-term outcome of infants with positional occipital plagiocephaly. Childrens Nervous System, 23, 1275-1283.
• van Vlimmeren, L. A., van der Graaf, Y., Boere- Boonekamp, M. M., L'Hoir, M. P., Helders, P. J., & Engelbert, R. H. (2008). Effect of pediatric physical therapy on deformational plagiocephaly in children with positional preference: a randomised controlled trial. Archives of Pediatric & Adolescent Medicine, 712-718.