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Plagiocephaly, NonsynostoticNCT04672837

Pediatric Integrative Manual Therapy in Babies With Deformational Plagiocephaly and Congenital Muscular Torticollis

A study testing Pediatric Integrative Manual Therapy and educational therapy and Stretching and educational therapy in people with Plagiocephaly, Nonsynostotic and Plagiocephaly, Positional, run by Universidad de Zaragoza at 1 site in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study evaluates the efficacy of Pediatric Integrative Manual Therapy in the treatment of positional plagiocephaly in infants. 25 participants will receive a protocol of Pediatric Integrative Manual Therapy and educational physiotherapy in combination, while the other 25 will receive a stretching protocol and… Read more about this study

Who is it for?
Ages 0 to 12 months
What is being tested?
Pediatric Integrative Manual Therapy and educational therapy and Stretching and educational therapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteSpain
Study dates
1 Jun 2019to 30 Jun 2023
Phase
Interventional
Are there results?
None posted in the registry

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 0 to 12 months
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Sign of positional plagiocephaly
  • Infants below 12 moths age

Who cannot join

  • No neurological disorders
  • No infectious diseases
  • No respiratory diseases
  • No other treatments

Trial locations and contacts

1 site in 1 country.

Iñaki Pastor Pons contact

+34657272757

inakipas@gmail.com

Spain1 site, 1 recruiting
  • Instituto deTerapias Integrativas

    Zaragoza, 50001

    Iñaki Pastor Pons, +34657272757, inakipas@gmail.com

    Elena Lecha, +34 976284470, elena@itifisioterapia.com

    Recruiting

Other trials in Spain

About this study

Official title: Efficacy of Pediatric Integrative Manual Therapy in Babies With Deformational Plagiocephaly and Congenital Muscular Torticollis

This study evaluates the efficacy of Pediatric Integrative Manual Therapy in the treatment of positional plagiocephaly in infants. 25 participants will receive a protocol of Pediatric Integrative Manual Therapy and educational physiotherapy in combination, while the other 25 will receive a stretching protocol and educational physiotherapy

Read the detailed description

The Manual Therapy has shown efficacy in different pathologies in the adult but it is not know its utility in infants and children population, nor in specific pathologies as non synostotic plagiocephaly.

In the conservative treatment of plagiocephaly the educational physiotherapy and the helmet therapy have the better level of evidence among other treatments. When babies present preferential position of the head or Congenital Muscular Torticollis, stretching has shown efficacy.

A protocol of ten sessions of Pediatric Manual Therapy will be applied to infants with positional plagiocephaly in combination with educational physiotherapy. The protocol consists in soft cervical mobilisation, myofascial induction and the application of some pressures to the cranial bones to improve the asymmetry of the head. Educational therapy which consists in more "tummy time" stimulation, stimulation to the non preference position of the head and counter positioning. The control group will receive a protocol of stretching at home done by their parents and Educational therapy.

Being tested
Pediatric Integrative Manual Therapy and educational therapy, Stretching and educational therapy
Keywords
Manual Therapy, Physical Therapy, Cranial Asymmetry, Preferential position of the head
Medical subject headings
Plagiocephaly, Nonsynostotic, Congenital torticollis

What participants receive

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

  • Pediatric Integrative Manual Therapy and educational therapyProcedure or surgery

    Pediatric Integrative Manual Therapy is a soft Orthopedic Manual Therapy approach por infants and children. It integrates joints soft mobilisation, myofascial release and neurodynamic mobilisation. Also the educational therapy.

  • Stretching and educational therapyProcedure or surgery

    It is a protocol of stretching based on literature research. Also the educational therapy with counter positioning, stimulation in prone position, positional care, etc.

Study groups in NCT04672837
Study groupRoleWhat they receive
Manual Therapy GroupExperimental10 sessions of Pediatric Manual Therapy, once a week. Soft cervical mobilisation, myofascial induction and cranial techniques will be administered. Educational physiotherapy consists in "tummy time" stimulation, visual and kinaesthetic stimulation on the non preferential head position and counter position will be also administered.
Receives: Procedure: Pediatric Integrative Manual Therapy and educational therapy
Stretching GroupActive comparatorA protocol of Stretching at home. 3-5 sessions twice a day. Each stretch will be maintain10 to 30 seconds. Each session 15 will take no less than 15 minutes. 7 days a week. Educational Physical Therapy consists in "tummy time" stimulation, visual and kinaesthetic stimulation on the non preferential head position and counter position will be administered.
Receives: Procedure: Stretching and educational therapy

What is being measured

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

  1. Right Oblique Cranial Vault Diameter

    Measured with caliper, is the distance from left external part of the orbit to the right lambdoid suture at the horizontal plane

    Measured: 4 weeks

  2. Right Oblique Cranial Vault Diameter

    Measured with caliper, is the distance from left external part of the orbit to the right lambdoid suture at the horizontal plane

    Measured: 10 weeks

  3. Left Oblique Cranial Vault Diameter

    Measured with caliper, is the distance from right external part of the orbit to the left lambdoid suture at the horizontal plane

    Measured: 4 weeks

  4. Left Oblique Cranial Vault Diameter

    Measured with caliper, is the distance from right external part of the orbit to the left lambdoid suture at the horizontal plane

    Measured: 10 weeks

  5. Active Cervical Rotation Range of movement

    Measured with photographs and digital angular analysis

    Measured: 4 weeks

  6. Active Cervical Rotation Range of movement

    Measured with digital angular analysis

    Measured: 10 weeks

  7. Passive Cervical Rotation Range of movement

    Measured lying down with joint goniometer

    Measured: 4 weeks

  8. Passive Cervical Rotation Range of movement

    Measured lying down with joint goniometer

    Measured: 10 weeks

  9. Passive Cervical Lateral Flexion Range of movement

    Measured lying down with joint goniometer

    Measured: 4 weeks

  10. Passive Cervical Lateral Flexion Range of movement

    Measured lying down with joint goniometer

    Measured: 10 weeks

  11. Muscle Function Test

    Measured in lateral suspension giving a value of 0 to 5 according to the alignment of the head with the trunk

    Measured: 4 weeks

  12. Muscle Function Test

    Measured in lateral suspension giving a value of 0 to 5 according to the alignment of the head with the trunk

    Measured: 10 weeks

Secondary outcomes (9)
  1. Cranial length

    Measured with calliper, is the distance from most anterior point in the frontal bone in the middle line to the most posterior point in the cranial vault on the horizontal plane in the middle line

    Measured: 4 weeks and 10 weeks

  2. Cranial length

    Measured with calliper, is the distance from most anterior point in the frontal bone in the middle line to the most posterior point in the cranial vault on the horizontal plane in the middle line

    Measured: 10 weeks

  3. Cranial wide

    Measured with calliper, is the distance between the two more lateral points in the vault, usually in the temporal or parietal bone.

    Measured: 4 weeks

  4. Cranial wide

    Measured with calliper, is the distance between the two more lateral points in the vault, usually in the temporal or parietal bone.

    Measured: 10 weeks

  5. Cranial maximal circumference

    Measured in cm with a measuring tape.

    Measured: 4 weeks

  6. Cranial maximal circumference

    Measured in cm with a measuring tape.

    Measured: 10 weeks

  7. Alberta Infant Motor Scale

    Neuromotor scale for infants from 0 to 14 months. Maximum value 90th; minimum value 0th. Higher scores indicate a better motor and postural development. Values below 15th indicate risk of development delay.

    Measured: 10 weeks

  8. Visual Analogical Scale about improvement in cervical movement after intervention

    Parents perception of changes in their baby. Minimum value -10; maximum value +10. Higher scores indicate a better perception of change in the cervical movement.

    Measured: 10 weeks

  9. Visual Analogical Scale about improvement in cranial asymmetry after intervention

    Parents perception of changes in their baby. Minimum value -10; maximum value +10. Higher scores indicate a better perception of change in the head shape

    Measured: 10 weeks

Timeline

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

  1. First posted17 Dec 2020
  2. Study start1 Jun 2019
  3. Primary completion30 May 2023 (estimated)
  4. Study completion30 Jun 2023 (estimated)

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
Parallel assignment
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04672837
Sponsor's protocol ID
PMT2
Status last verified
May 2022
First submitted
2 Dec 2020
Last updated
20 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Billi M, Greco A, Colonneli P, Volpi G, Valente D, Galeoto G. The functional manual therapy intervention in infants with non-synostotic plagiocephaly: a pilot study. Minerva Pediatr (Torino). 2022 Jun;74(3):294-300. doi: 10.23736/S2724-5276.17.04838-1. Epub 2017 Oct 25.

    PubMed 29072040
  • Cabrera-Martos I, Valenza MC, Valenza-Demet G, Benitez-Feliponi A, Robles-Vizcaino C, Ruiz-Extremera A. Effects of manual therapy on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly: a randomised controlled pilot study. Childs Nerv Syst. 2016 Nov;32(11):2211-2217. doi: 10.1007/s00381-016-3200-5. Epub 2016 Jul 27.

    PubMed 27465676
  • Bagagiolo D, Didio A, Sbarbaro M, Priolo CG, Borro T, Farina D. Osteopathic Manipulative Treatment in Pediatric and Neonatal Patients and Disorders: Clinical Considerations and Updated Review of the Existing Literature. Am J Perinatol. 2016 Sep;33(11):1050-4. doi: 10.1055/s-0036-1586113. Epub 2016 Sep 7.

    PubMed 27603533
  • Ballardini E, Sisti M, Basaglia N, Benedetto M, Baldan A, Borgna-Pignatti C, Garani G. Prevalence and characteristics of positional plagiocephaly in healthy full-term infants at 8-12 weeks of life. Eur J Pediatr. 2018 Oct;177(10):1547-1554. doi: 10.1007/s00431-018-3212-0. Epub 2018 Jul 20.

    PubMed 30030600
  • Williams E. Preventing "Flat-headed" Babies: A Commentary on "Impact of Parent Practices of Infant Positioning on Head Orientation Profile and Development of Positional Plagiocephaly in Healthy Term Infants". Phys Occup Ther Pediatr. 2018 Feb;38(1):15-17. doi: 10.1080/01942638.2018.1405661. No abstract available.

    PubMed 29372872
  • Nahles S, Klein M, Yacoub A, Neyer J. Evaluation of positional plagiocephaly: Conventional anthropometric measurement versus laser scanning method. J Craniomaxillofac Surg. 2018 Jan;46(1):11-21. doi: 10.1016/j.jcms.2017.10.010. Epub 2017 Oct 16.

    PubMed 29137851
  • van Vlimmeren LA, Engelbert RH, Pelsma M, Groenewoud HM, Boere-Boonekamp MM, der Sanden MW. The course of skull deformation from birth to 5 years of age: a prospective cohort study. Eur J Pediatr. 2017 Jan;176(1):11-21. doi: 10.1007/s00431-016-2800-0. Epub 2016 Nov 4.

    PubMed 27815732
  • Aarnivala H, Vuollo V, Harila V, Heikkinen T, Pirttiniemi P, Valkama AM. Preventing deformational plagiocephaly through parent guidance: a randomized, controlled trial. Eur J Pediatr. 2015 Sep;174(9):1197-208. doi: 10.1007/s00431-015-2520-x. Epub 2015 Apr 1.

    PubMed 25823758
  • De Bock F, Braun V, Renz-Polster H. Deformational plagiocephaly in normal infants: a systematic review of causes and hypotheses. Arch Dis Child. 2017 Jun;102(6):535-542. doi: 10.1136/archdischild-2016-312018. Epub 2017 Jan 19.

    PubMed 28104626
  • Ohman A, Mardbrink EL, Stensby J, Beckung E. Evaluation of treatment strategies for muscle function in infants with congenital muscular torticollis. Physiother Theory Pract. 2011 Oct;27(7):463-70. doi: 10.3109/09593985.2010.536305. Epub 2011 May 15.

    PubMed 21568831
  • Ohman A, Nilsson S, Beckung E. Stretching treatment for infants with congenital muscular torticollis: physiotherapist or parents? A randomized pilot study. PM R. 2010 Dec;2(12):1073-9. doi: 10.1016/j.pmrj.2010.08.008.

    PubMed 21145518
  • Ohman AM, Nilsson S, Beckung ER. Validity and reliability of the muscle function scale, aimed to assess the lateral flexors of the neck in infants. Physiother Theory Pract. 2009 Feb;25(2):129-37. doi: 10.1080/09593980802686904.

    PubMed 19212900
  • Di Chiara A, La Rosa E, Ramieri V, Vellone V, Cascone P. Treatment of Deformational Plagiocephaly With Physiotherapy. J Craniofac Surg. 2019 Oct;30(7):2008-2013. doi: 10.1097/SCS.0000000000005665.

    PubMed 31232996
  • Systematic Review and Evidence-Based Guidelines for the Management of Patients with Positional Plagiocephaly. Pediatrics. 2016 Nov;138(5):e20162802. doi: 10.1542/peds.2016-2802. No abstract available.

    PubMed 27940801

Questions about this trial

What is this clinical trial studying?

A study testing Pediatric Integrative Manual Therapy and educational therapy and Stretching and educational therapy in people with Plagiocephaly, Nonsynostotic and Plagiocephaly, Positional, run by Universidad de Zaragoza at 1 site in Spain.

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 4 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: status not confirmed, as of the sponsor's last update on 20 May 2022. 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 Spain. 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. 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?

Results are not available in the source record.

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

Contact Iñaki Pastor Pons (+34657272757, inakipas@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Right Oblique Cranial Vault Diameter (time frame: 4 weeks). The study lists 12 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 NCT04672837, which also lists 14 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 20 May 2022.

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