Abstract
ObjectiveCraniofacial measuring is valuable for diagnosis and evaluation of growth and treatment of positional skull deformities. Plagiocephalometry (PCM) quantifies skull deformities and is proven to be reliable and valid. However, PCM needs direct skin contact with thermoplastic material, is laborious and time-consuming. Therefore, Skully Care (SC) was developed to measure positional skull deformities with a smartphone application.DesignSC is retrospectively compared to PCM.SettingPediatric physiotherapy centers.PatientsAge ≤1 year, analyzed or treated for positional skull deformities.InterventionsA total of 60 skull shape analyses were performed.Main Outcome MeasuresThe main outcome measures employed are Pearson correlation coefficient between cranial vault asymmetry index (CVAI; in SC) and oblique diameter difference index (ODDI; in PCM) and between cranial index (CI; in SC) and cranial proportional index (CPI; in PCM). Mann–Whitney U test determined difference of time consumption between PCM and SC.ResultsHigh correlation was found between CVAI and ODDI (r = 0.849; P < .01) in positional plagiocephaly and very high correlation between CI and CPI (r = 0.938; P < .01) in positional brachycephaly. SC is significantly faster than PCM (P < .001).ConclusionsSC is valid in analyzing positional skull deformities and strongly correlates to PCM, the gold standard in daily physiotherapy practice. The combination of simplicity, validity, speed, and user and child convenience makes SC a promising craniofacial measuring method in daily practice. SC has potential to be the modern successor for analyzing positional skull deformities.
Highlights
Positional skull deformities in newborns and young children are a common problem in daily clinical practice (van Vlimmeren et al, 2006)
If children are suspected for positional skull deformations, they are referred to pediatric physiotherapy centers
High correlation was found between cranial vault asymmetry index (CVAI) and oblique diameter difference index (ODDI) (r = 0.849; P < .01; Figure 3)
Summary
Positional skull deformities in newborns and young children are a common problem in daily clinical practice (van Vlimmeren et al, 2006). The primary diagnosis of positional skull deformities, such as positional plagiocephaly, positional brachycephaly, and positional scaphocephaly, is based on clinical history taking and physical examination. In positional skull deformities, physical examination alone is not accurate enough for outcome measurement. The Argenta classification is used for the establishment of severity of the skull shape; this method is a visual assessment and is subjective and not quantitative (Argenta et al, 2004; Feijen et al, 2012). Caliper measurement is frequently used in the clinical setting; this method is objective, but the interrater reliability of caliper measurements ranges
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