Objectives: This study aimed to determine whether the inclusion of chiropractic manipulative therapy (CMT) during helmet therapy reduced the treatment duration and improved measurement outcomes for infants with moderate to severe positional plagiocephaly.
Methods: This was a retrospective cohort study using clinical records from a South African orthotist. Infants aged 4–12 months with moderate to severe nonsynostotic plagiocephaly were divided into two groups: those who received helmet therapy alone (control) and those who received helmet therapy combined with CMT (intervention). The primary outcome was treatment duration (weeks); secondary outcomes included changes in cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI), measured using SmartSoc® 3D scanning technology.
Results: Of the 128 eligible infants, 61 families responded and gave consent, 24 infants met the inclusion criteria (12 control, 12 intervention). The mean treatment duration showed no significant difference between groups. However, the intervention group achieved significantly better cranial symmetry outcomes, with final CVA (p = .010) and CVAI (p = 0.010) values lower than the control group and more change for both CVA (p = .755) and CVAI (p = .693) than the control group.
Conclusions: While the addition of CMT did not shorten the duration of helmet therapy, it was associated with superior cranial symmetry outcomes at discharge, potentially indicating more efficient symmetry correction. These findings suggest potential added value in combining CMT with helmet therapy in improving cranial symmetry. Further prospective studies with larger samples and standardized chiropractic protocols are warranted to confirm these preliminary observations.
Keywords: Chiropractic, manual therapy, plagiocephaly, helmet therapy, orthotic devices
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