Plagiocephaly, cervical spine function and heart rate variability

RESEARCHERS

  1. Dr Chandan Karmakar PhD
    Senior Lecturer, Computer Science
    School of Information Technology, Deakin University, Burwood, VIC 3125.
    read more…

  2. Dr Shariful Islam MBBS, MPH, PhD, FESC
    Institute for Physical Activity and Nutrition (IPAN)
    School of Exercise and Nutrition Sciences, Faculty of Health
    read more…

  3. Dr Braden Keil BAppSc(Chiro) MCSc(Paeds) FICC FACCP
    Senior Lecturer, Chiropaeds Australia
    Private Practice

  4. Dr Christian Fludder BChiroSc, MChiro, DACCP
    Lecturer, Chiropaeds Australia
    Private Practice

 

BACKGROUND

Plagiocephaly, a condition involving changes to the normal symmetry of the head, is a condition with an estimated prevalence of up to 40% in infants between 3-12 months of age.(1,2) While often perceived as a cosmetic issue, evidence exists demonstrating associations between plagiocephaly and developmental delay.(3,4) The mechanism behind this delay is still uncertain, however researchers have identified a link between plagiocephaly and restrictions in normal cervical spine motion.(5,6)

The cervical spine provides significant levels of cortical afferentation via stimulation from proprioceptive and spinal trigeminal fibres originating in the upper cervical spine. This mechanism of utilising cranial nerves for cortical stimulation is critical for the normal development of the brain. Utilising heart rate variability (HRV) measurements, the activity of the Vagus nerve (cranial nerve 10) as well as the balance of the sympathetic/parasympathetic system can be elucidated. By comparing the results of infants with plagiocephaly with known values of normal, one potential causative factor for developmental delays may be determined.

RESEARCH QUESTIONS:

  1. Do infants presenting at 4-6 months of age with plagiocephaly demonstrate abnormal HRV?

  2. Do infants presenting at 4-6 months of age with plagiocephaly and abnormal cervical spine function demonstrate abnormal HRV?

  3. Do infants presenting at 4-6 months of age with plagiocephaly and normal cervical spine function demonstrate abnormal HRV?

  4. Do infants with plagiocephaly and abnormal HRV undergoing helmet therapy demonstrate improved HRV?

  5. Does prior or current manual therapy affect the HRV in infants with plagiocephaly?

 

REFERENCES

  1. Ballardini E, Sisti M, Basaglia N, et al. Prevalence and characteristics of positional plagiocephaly in healthy full-term infants at 8–12 weeks of life. Eur J Pediatr. 2018;177(10):1547-1554. doi:10.1007/s00431-018-3212-0

  2. Di Rocco F, Ble V, Beuriat PA, Szathmari A, Lohkamp LN, Mottolese C. Prevalence and severity of positional plagiocephaly in children and adolescents. Acta Neurochir (Wien). 2019;161(6):1095-1098. doi:10.1007/s00701-019-03924-2

  3. Kim DH, Kwon DR. Neurodevelopmental delay according to severity of deformational plagiocephaly in children. Medicine (Baltimore). 2020;99(28):e21194. doi:10.1097/MD.0000000000021194

  4. Martiniuk ALC, Vujovich-Dunn C, Park M, Yu W, Lucas BR. Plagiocephaly and Developmental Delay: A Systematic Review. J Dev Behav Pediatr. 2017;38(1):67-78. doi:10.1097/DBP.0000000000000376

  5. Murgia M, Venditto T, Paoloni M, et al. Assessing the cervical range of motion in infants with positional plagiocephaly. J Craniofac Surg. 2016;27(4):1060-1064. doi:10.1097/SCS.0000000000002644

  6. Fludder CJ, Keil BG. Deformational Plagiocephaly and Reduced Cervical Range of Motion: A Pediatric Case Series in a Chiropractic Clinic. Altern Ther Health Med. 2020;(1):3-9.