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Nonsynostotic PlagiocephalyNCT03970395

Effectiveness of Osteopathic Manipulative Therapy in Nonsynostotic Plagiocephaly

A study testing Osteopathic manipulative therapy (OMTh), Light Touch Therapy (LTT) and Repositioning therapy in people with Nonsynostotic Plagiocephaly, run by PRIOLO CLAUDIO at 1 site in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this trial is to evaluate the effectiveness of osteopathic manipulative therapy in reducing the asymmetries of skull in infants with nonsynostotic plagiocephaly. Read more about this study

Who is it for?
Ages 1 month to 6 months
Conditions the study is for
Nonsynostotic Plagiocephaly
What is being tested?
Osteopathic manipulative therapy (OMTh), Light Touch Therapy (LTT) and Repositioning therapy
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
96 participants
Where
1 siteItaly
Study dates
1 Sep 2016to 26 Feb 2020
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 month to 6 months
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Infants with NSP, ODDI score of 104% or more.
  • To be at term corrected age if born prematurely.

Who cannot join

  • Synostotic Plagiocephaly
  • Infant who underwent an osteopathic manipulative treatment before the enrolment
  • Dysmorphisms
  • Syndromes
  • Congenital Muscular Torcicolis
  • Cerebral Palsy

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Universitaria Città della Salute e della Scienza.

    Torino, 10126

Other trials in Italy

About this study

The aim of this trial is to evaluate the effectiveness of osteopathic manipulative therapy in reducing the asymmetries of skull in infants with nonsynostotic plagiocephaly.

Read the detailed description

Nonsynostotic plagiocephaly (NSP) is defined as the deformation of the head resulting from external forces that mould the skull during the first months of life.

Four months seems to be a critical age for the development of NSP, but many positional head shape deformities may improve with time.

Early assessment and diagnosis is important not only for the shape of the skull, but also for possible clinical significant differences in gross motor development.

In paediatric conditions the effect of osteopathic manipulative treatment is documented in systematic reviews; in NSP the only study, which is a pilot, reveals an average reduction of 50% asymmetry on 12 infants who have undergone a course of four osteopathic treatments.

Being tested
Osteopathic manipulative therapy (OMTh), Light Touch Therapy (LTT), Repositioning therapy
Keywords
Positional Plagiocephaly, Deformational Plagiocephaly,
Medical subject headings
Plagiocephaly, Nonsynostotic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Osteopathic manipulative therapy (OMTh)Other

    The Osteopathic Manipulative Therapy includes evaluation and treatment. The evaluation considers the pelvic girdle and lower limb, thorax abdominal area, pectoral girdle and upper limbs, cervical and upper thoracic area, cranial vault, cranial base and viscero cranium. The treatment is based on balanced ligamentous tension technique, myofascial release, visceral manipulation, and balanced membranous tension technique. The OMTh lasts for 45 minutes of which 15 minutes of evaluation and 30 minutes of treatment.

  • Light Touch Therapy (LTT)Other

    The LTT is consistent with the OMT during the phase of evaluation. The treatment retains the same areas used for osteopathic approach but avoids prolonged touch in any area of the body, moving the hands every few seconds, and by flattening and softening the surface of the hands to minimize focal areas of force.

  • Repositioning therapyOther

    It consists of strategies that guide the parents to position the baby "back to sleep", by alternating head position, the use of tummy time while supervised, and the infants must spend minimal time in car seats or other devices that promote supine positions. In active counter-positioning the parents are suggested to place some toys on the side of the head where neck rotation is limited while, when using the changing table, to alternate the end of the table at which the infant's head is placed.

Study groups in NCT03970395
Study groupRoleWhat they receive
Osteopathic manipulative therapyExperimentalRepositioning Therapy plus Osteopathic Manipulative Therapy (OMTh). Osteopathic Manipulative Therapy. Participant OMT group receive 6 OMTh in 3 months, as follows: first at baseline, the second after 1 week, the third after 3 weeks, and then once every 3 weeks for three more visits.
Receives: Other: Osteopathic manipulative therapy (OMTh); Other: Repositioning therapy
Light Touch TherapySham comparatorRepositioning Therapy plus Light Touch Therapy (LTT) Participants to the LTT group receive the LTT protocol at the same date of the OMTh group.
Receives: Other: Light Touch Therapy (LTT); Other: Repositioning therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Change From Baseline in ODDI Score (Oblique Diameter Difference Index) to Below 104% at 3 Months

    The ODDI score being the most clinically relevant measure to define nonsynostotic plagiocephaly.

    The category of nonsynostotic plagiocephaly is defined by reference to the following score:

    ODDI score >=104 Nonsynostotic Plagiocephaly ODDI score <104 Absence of Nonsynostotic Plagiocephaly Higher score means a worse outcome.

    Measured: Baseline and 3 months

  2. Number of Participants With Change From Baseline in ODDI Score (Oblique Diameter Difference Index) to Below 104% at 1 Year of Age.

    The ODDI score being the most clinically relevant measure to define nonsynostotic plagiocephaly.

    The category of nonsynostotic plagiocephaly is defined by reference to the following score:

    ODDI score >=104 Nonsynostotic Plagiocephaly ODDI score <104 Absence of Nonsynostotic Plagiocephaly Higher score means a worse outcome.

    Measured: Follow-up at 1 year of age

  3. Number of Participants With Change From Baseline in ODDI Score (Oblique Diameter Difference Index) to Below 104% at 3 Months

    The ODDI score being the most clinically relevant measure to define nonsynostotic plagiocephaly.

    The category of nonsynostotic plagiocephaly is defined by reference to the following score:

    ODDI score >=104 Nonsynostotic Plagiocephaly ODDI score <104 Absence of Nonsynostotic Plagiocephaly Higher score means a worse outcome.

    Measured: At 3 months

  4. Number of Participants With Change From Baseline in ODDI Score (Oblique Diameter Difference Index) to Below 104% at 1 Year of Age.

    The ODDI score being the most clinically relevant measure to define nonsynostotic plagiocephaly.

    The category of Nonsynostotic plagiocephaly is defined by reference to the following score:

    ODDI score >=104<108 MILD Nonsynostotic Plagiocephaly ODDI score >=108<112 MODERATE Nonsynostotic Plagiocephaly ODDI score >= 112 SEVERE Nonsynostotic Plagiocephaly Higher score means a worse outcome.

    Measured: Follow-up at one year of age

Secondary outcomes (2)
  1. Cranial Proportion Index (CPI)

    Change of the width and length diameter measured with Plagiocephalometry.

    Measured: The change of CPI will be measured at baseline, at 3 months from baseline and follow-up at 1 year of age.

  2. Adverse Event

    Symptoms such as irritability accured after the Osteopathic Manipulative Therapy or Light Touch Therapy

    Measured: From first treatment (1 week post-baseline) up to end of treatment course (3 months).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 May 2019
  2. Study start1 Sep 2016
  3. Primary completion26 Feb 2020
  4. Study completion26 Feb 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
A two arms randomized controlled trial. The experimental group will receive Osteopathic manipulative Therapy and the active comparator the Light Touch Therapy
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
96 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03970395
Sponsor's protocol ID
0074260
Status last verified
Feb 2021
First submitted
5 May 2019
Last updated
12 Feb 2021
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Rogers GF. Deformational plagiocephaly, brachycephaly, and scaphocephaly. Part I: terminology, diagnosis, and etiopathogenesis. J Craniofac Surg. 2011 Jan;22(1):9-16. doi: 10.1097/SCS.0b013e3181f6c313.

    PubMed 21187783
  • Rogers GF. Deformational plagiocephaly, brachycephaly, and scaphocephaly. Part II: prevention and treatment. J Craniofac Surg. 2011 Jan;22(1):17-23. doi: 10.1097/SCS.0b013e3181f6c342.

    PubMed 21187782
  • Lennartsson F. Developing guidelines for child health care nurses to prevent nonsynostotic plagiocephaly: searching for the evidence. J Pediatr Nurs. 2011 Aug;26(4):348-58. doi: 10.1016/j.pedn.2010.07.003. Epub 2010 Sep 25.

    PubMed 21726785
  • Lessard S, Gagnon I, Trottier N. Exploring the impact of osteopathic treatment on cranial asymmetries associated with nonsynostotic plagiocephaly in infants. Complement Ther Clin Pract. 2011 Nov;17(4):193-8. doi: 10.1016/j.ctcp.2011.02.001. Epub 2011 Mar 5.

    PubMed 21982132
  • van Vlimmeren LA, Takken T, van Adrichem LN, van der Graaf Y, Helders PJ, Engelbert RH. Plagiocephalometry: a non-invasive method to quantify asymmetry of the skull; a reliability study. Eur J Pediatr. 2006 Mar;165(3):149-57. doi: 10.1007/s00431-005-0011-1. Epub 2005 Oct 7.

    PubMed 16211401
  • Bagagiolo D, Priolo CG, Favre EM, Pangallo A, Didio A, Sbarbaro M, Borro T, Dacco S, Manzoni P, Farina D. A Randomized Controlled Trial of Osteopathic Manipulative Therapy to Reduce Cranial Asymmetries in Young Infants with Nonsynostotic Plagiocephaly. Am J Perinatol. 2022 Dec;39(S 01):S52-S62. doi: 10.1055/s-0042-1758723. Epub 2022 Nov 30.

    PubMed 36451623

Questions about this trial

What is this clinical trial studying?

A study testing Osteopathic manipulative therapy (OMTh), Light Touch Therapy (LTT) and Repositioning therapy in people with Nonsynostotic Plagiocephaly, run by PRIOLO CLAUDIO at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 24 Sep 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Change From Baseline in ODDI Score (Oblique Diameter Difference Index) to Below 104% at 3 Months (time frame: Baseline and 3 months). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03970395, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Feb 2021.

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