Time to successful outcome vs. treatment duration in cranial remolding orthosis treatment

Michigan Cranial Reshaping Orthosis. HHS Vulnerability Disclosure

Abstract
Background

Cranial remolding orthoses are an effective treatment of deformational plagiocephaly. Typical treatment durations are well documented. However, treatment duration can be affected by multiple factors and may not be a true representation of the time necessary to achieve a successful clinical outcome.

Objective

This study compared the time to achieve a successful clinical outcome against the total treatment duration for cranial remolding orthosis therapy in infants with deformational plagiocephaly.

Study design

This is a retrospective study of infants treated for deformational plagiocephaly with a cranial remolding orthosis.

Methods

A total of 300 infants with deformational plagiocephaly who were treated with a cranial remolding orthosis were grouped by corrected age at initiation of treatment and by severity of deformity. A successful outcome was defined as achieving a final cranial vault asymmetry of 5 mm or less. For the 226 infants who achieved a successful outcome, time to successful outcome and treatment duration were compared between the groups.

Results

The time to successful outcome depended on severity but not on age at initiation. The median time to successful outcome ranged from 6 weeks to 17.5 weeks, depending on the severity of the deformity. Time to successful outcome was significantly shorter than treatment duration for infants with an initial cranial vault asymmetry of less than 17 mm.

Conclusion

Current treatment durations for infants with moderate plagiocephaly may be longer than necessary. Estimated treatment time lines should be based on the initial severity of the infant’s deformity.

Keywords

cranial remolding orthosis; cranial vault asymmetry (CVA); plagiocephaly; premature birth; severity; treatment duration; treatment outcome.

Conflict of interest statement

Conflict of interest: The authors worked at the University of Michigan while working on the study and none of them have conflicts of interest to disclose. None of the authors were the treating clinicians of the infants in the study.

References

Time to successful outcome vs. treatment duration in cranial remolding orthosis treatment, Petz AM, Vallery CE, Richards CJ, Gensch HT, Yosef M, Khalatbari SH, Frank CJ, Richards JA. Prosthet Orthot Int. 2025 Oct 1;49(5):502-507. doi: 10.1097/PXR.0000000000000388. Epub 2024 Nov 5.

Copyright © 2024 International Society for Prosthetics and Orthotics
Source Prosthetics and Orthotics International
Further reading

A 10-Year Review of the Efficacy of Cranial Remolding Orthosis Treatment and Factors That Influence Outcomes for Infants with Isolated Deformational Plagiocephaly, Trebilcock AL, Findley JL, Cherry JS, Kasparek JA, Gordon MM, Beals SP, Littlefield TR. Children (Basel). 2025 Aug 21;12(8):1099. doi: 10.3390/children12081099.

 

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