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纳入保守治疗方案的畸形斜头畸形婴儿的临床特征及病情发展

Clinical profile and evolution of infants with deformational plagiocephaly included in a conservative treatment program.

作者信息

Cabrera-Martos I, Valenza M C, Benítez-Feliponi A, Robles-Vizcaíno C, Ruiz-Extremera A, Valenza-Demet G

机构信息

Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av de Madrid SN, 18071, Granada, Spain.

出版信息

Childs Nerv Syst. 2013 Oct;29(10):1893-8. doi: 10.1007/s00381-013-2120-x. Epub 2013 May 5.

Abstract

PURPOSE

The aim of this study was to evaluate the results of a conservative intervention in infants with plagiocephaly according to their specific clinical profile.

METHODS

Prospective clinical trial in which 104 infants with plagiocephaly accompanied or not by congenital or positional torticollis were referred to Early Care and Monitoring Unit (USAT) of San Cecilio Hospital in Granada, between 2009 and 2012. All the infants, grouped into three categories of severity, were included in the physiotherapy protocol until adequate craniofacial morphology and motor development were achieved. The study included an assessment of parents and infants. Parents were assessed with a questionnaire about the mother's medical history and birth-related issues. The assessment of infants included anthropometric measures, a positional assessment, the observation of the head, the assessment of severity, and motor development.

RESULTS

Birth characteristics were similar in the total sample but showed different clinical profiles according to treatment aspects. More specifically, infants with severe plagiocephaly were referred to treatment later and spent more time in treatment; use of an orthotic helmet was also more prevalent in this category. There were also significant differences (P < 0.05) in the acquisition of specific gross motor skills depending on the severity of plagiocephaly.

CONCLUSION

The findings suggest that the physiotherapy protocol presented is effective to correct plagiocephaly. Severity of plagiocephaly is a marker that should be taken into account when designing actions aimed at improving gross motor skill development.

摘要

目的

本研究旨在根据特定临床特征评估对斜头畸形婴儿进行保守干预的效果。

方法

这是一项前瞻性临床试验,2009年至2012年间,104例伴有或不伴有先天性或姿势性斜颈的斜头畸形婴儿被转诊至格拉纳达圣塞西利奥医院的早期护理与监测单元(USAT)。所有婴儿被分为三个严重程度类别,均纳入物理治疗方案,直至实现足够的颅面形态和运动发育。该研究包括对家长和婴儿的评估。通过一份关于母亲病史和出生相关问题的问卷对家长进行评估。对婴儿的评估包括人体测量、姿势评估、头部观察、严重程度评估和运动发育评估。

结果

总样本的出生特征相似,但根据治疗方面显示出不同的临床特征。更具体地说,严重斜头畸形的婴儿转诊接受治疗的时间较晚,且治疗时间更长;此类婴儿使用矫形头盔的情况也更为普遍。根据斜头畸形的严重程度,在获得特定的粗大运动技能方面也存在显著差异(P < 0.05)。

结论

研究结果表明,所提出的物理治疗方案对矫正斜头畸形有效。斜头畸形的严重程度是设计旨在改善粗大运动技能发育的行动时应考虑的一个指标。

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