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A Case Study of Osteopathic Manipulative Treatment (OMT) in Deformational Plagiocephaly (DP)

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 15. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/10/493538/LBORC-NUFA-Poster-Abstracts-2023-Residents)

Keywords:

case report [514]
newborn [58]
OMT [2951]
osteopathic manipulative treatment [2973]
pediatrics [375]
plagiocephaly [41]
preterm infants [15]

Abstract:

Introduction/Background: DP is an asymmetric head shape due to unilateral flattening, an abnormality that may result from prematurity with increased hospital stay with prolonged supine positioning, or congenital torticollis. Risk factors also include being male and premature birth. Diagnosis of DP is made upon physical exam (PE) by a pediatrician at 2 months of age. Treatment for DP ranges from caregiver education on repositioning and physical therapy, to cranial orthotics and surgery. Currently, treatment recommendations do not include Osteopathic Cranial Manipulative Medicine (OCMM), a treatment modality offered by OMM specialists applied in the cranial region. Case: We present a case of a 4-month-old male diagnosed with DP, referred to the SBH Women’s Health Center (WHC) OMM clinic for further evaluation and management. His birth history is significant for preterm delivery via repeat cesarean section, and immediate admission into the neonatal intensive care unit for a total of 9 days, during which he received phototherapy for hyperbilirubinemia, requiring prolonged time in supine position. On initial OMT visit his PE was notable for right (R) frontal bossing and R occipitoparietal flattening. An osteopathic structural examination (OSE) was notable for midline supraocciput and bilateral intraosseous strains, and right upper and left lower sacral poles resistant to lateral distraction. OCMM and Balanced Ligamentous Tension (BLT) were applied for OMT. Results: By the 4th treatment, his mother reported decreased preference to R rotation, with significant improvement on PE of his R frontal bossing by the 6th visit. OSE in cranial and sacral regions developed lateralization and reduced. Discussion: OMT using OCMM and BLT, in addition to caregiver positional education, was used in this case to safely treat and help improve DP in this infant.


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