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CompletedNCT06173102Updated Jan 16, 2025

Cranial Orthosis Therapy for Plagiocephaly: an RCT Pilot Study Comparing Cranial Orthosis to the Natural Course

An interventional study of Cranial Orthosis in Plagiocephaly, Plagiocephaly, Nonsynostotic and Plagiocephaly, Positional, sponsored by St. Justine's Hospital. Completed at 1 site in Canada. Open to participants aged 122 Days to 212 Days. Per ClinicalTrials.gov, last updated 2025-01-16.

Sponsored by St. Justine's Hospital · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
24
Allocation
Randomized
Ages
122 Days to 212 Days
Sex
All
01

Study summary

Our study aims to assess the feasibility of a randomized controlled trial that investigates the efficacy of cranial orthosis therapy for treating severe deformational plagiocephaly in infants between 4 and 7 months old.

The main question it aims to answer are:

  • Feasibility of conducting the study in our physiatry clinic.

Participants will be randomized into two groups, receiving cranial orthosis at 1 week post initial visit, or the standard of care (7 weeks post initial visit). They will have head measurements and helmet adjustments as well as medical follow-up with a total of 4 visits. Post-treatment questionnaires will be filled out.

Read the detailed description

Our research endeavors to examine the feasibility of implementing a randomized controlled trial (RCT) that evaluates the efficacy of cranial orthosis therapy in addressing severe deformational plagiocephaly among infants aged 4 to 7 months.

Primary Objective: The central focus is on evaluating the feasibility aspects associated with the RCT design within our clinical setting.

Participants: Infants meeting the inclusion criteria will be recruited and randomized into two distinct groups:

  1. Treatment Group: Receiving cranial orthosis therapy initiated one week post their initial physiatrist visit.
  2. Control Group: Adhering to the standard of care, with cranial orthosis initiation at 7 weeks post their initial physiatrist visit.

Study Procedures: Participants in both groups will undergo a structured series of assessments and interventions, including:

  • Head measurements and 3D-scan evaluations to quantify cranial deformities.
  • Helmet adjustments by experienced orthotists based on growth and changes in head shape.
  • Regular medical follow-ups, totaling four visits during the course of the study.

Post-Treatment Assessments: Upon completion of the cranial orthosis therapy, participants will be required to fill out post-treatment questionnaires, providing valuable insights into their experiences, satisfaction levels, and any potential concerns

02

Conditions studied

  • Plagiocephaly
  • Plagiocephaly, Nonsynostotic
  • Plagiocephaly, Positional

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03

Who can participate

Ages eligible
122 Days to 212 Days
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • All participants must be assessed by a physiatrist at Sainte-Justine Hospital at the plagiocephaly clinic of the physical medicine and rehabilitation service.
  • Participants must have a clinical diagnosis of severe deformational plagiocephaly by a physiatrist based on clinical evaluation and confirmed by anthropometric measurements with a spreading caliper and 3D-scan.
  • Participants must be aged from 4 months and 0 days to 7 months old minus a day at the onset of cranial orthosis therapy. Premature subjects will be age-adjusted by calculating the post-partum age minus the number of weeks of prematurity, rounding to the whole nearest month.
  • Participants' parents (or legal guardian) must be apt to give consent and able to reliably express themselves (either written or verbally, if illiterate or unable to write for any other reason).

Exclusion criteria

Exclusion Criteria:

  • Patients whose 3D-scan measurements do not confirm a severe plagiocephaly.
  • Participants who are lost at follow-up or who drop out of treatment will be excluded.
  • Participants whose parents report less than 20 hours per day on average of helmet wear.
  • Participants with synostotic cranial deformation.
  • Patients with isolated brachycephaly, without a plagiocephalic component to the deformation.
  • Patients with other craniofacial deformities or syndromes.
  • Patients having had their orthosis made or modified at a laboratory other than the Sainte-Justine hospital/Centre de réadaptation Marie-Enfant.
04

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Single group
Masking
Single (Outcomes assessor)
Enrollment
24 participants (actual)

Study arms

  • Experimental
    Early Cranial Orthosis

    Early cranial orthosis (reception 1 week after initial visit)

    Device: Cranial Orthosis

  • Other
    Usual Cranial Orthosis

    Usual cranial orthosis (reception 7 weeks after initial visit)

    Device: Cranial Orthosis

Interventions

  • DeviceCranial Orthosis

    Early versus usual reception of orthosis.

05

What researchers measure

Primary outcomes

  1. Qualitative information on Feasibility

    documenting difficulties encountered during the pilot study, including but not limited to loss at follow-up, missed appointments, missing questionnaires, difficulties with enrollment, and coordination of appointments between the PM\&R service and the Orthotics clinic.

    Time frame: through study completion, average of 12 weeks per patient

Secondary outcomes

  1. Cranial Vault Asymmetry (CVA)

    The difference between the longest and shortest cranial diagonals, measured in millimeters.

    Time frame: at week 0, week 6 and week 12

  2. Cranial Vault Asymmetry Index (CVAI)

    A percentage value that considers the overall size of the head in relation to CVA.

    Time frame: at week 0, week 6 and week 12

  3. Parental Satisfaction:

    Measured with a parental questionnaire at the end of treatment, assessing satisfaction with head shape and cranial orthosis therapy.

    Time frame: through completion of study, on average 12 weeks per patient

  4. Adverse Effects:

    Any adverse effects observed during cranial orthosis therapy will be collected from parental questionnaires and medical chart records.

    Time frame: through completion of study, on average 12 weeks per patient

06

Study locations

1 site
  • Sainte-Justine Hospital
    Montréal, Quebec H3T 1C5, Canada
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT06173102
Lead sponsor
St. Justine's Hospital
Responsible party
Camille Costa (Associate Researcher, St. Justine's Hospital) — Principal investigator
First posted
Dec 15, 2023
Start date
Dec 7, 2023
Primary completion
Sep 9, 2024
Completion
Sep 9, 2024
Last update
Jan 16, 2025

Study contacts

Camille Costa, MD
principal investigator · Université de Montréal, CHU Sainte-Justine

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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