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Sports participation after craniosynostosis repair: the critical role of post-operative guidance in parental decision-making

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Abstract

Purpose

Despite previous research supporting patient safety in sports after craniosynostosis surgery, parental anxiety remains high. This study sought to evaluate the role of healthcare providers in guiding patients and families through the decision-making process.

Methods

Parents of children with repaired craniosynostosis were asked to assess sports involvement and parental decision-making in children ages 6 and older. Questions were framed primarily on 5-point Likert scales. Sport categorizations were made in accordance with the American Academy of Pediatrics. Chi-squared, linear regression, and Pearson correlation tests were used to analyze associations between the questions.

Results

Forty-three complete parental responses were recorded. Mean ages at surgery and time of sports entry were 7.93 ± 4.73 months and 4.76 ± 2.14 years, respectively. Eighty-two percent of patients participated in a contact sport. Discussions with the primary surgeon were more impactful on parental decisions about sports participation than those with other healthcare providers (4.04 ± 1.20 vs. 2.69 ± 1.32). Furthermore, children whose parents consulted with the primary surgeon began participating in sports at a younger age (4.0 ± 1.0 vs. 5.8 ± 2.7 years, p = 0.034). The mean comfort level with contact sports (2.8 ± 1.4) was lower than that with limited-contact (3.8 ± 1.1, p = 0.0001) or non-contact (4.4 ± 1.3, p < 0.0001) sports.

Conclusion

This study underscores the critical role that healthcare professionals, primarily surgeons, have in guiding families through the decision-making process regarding their children’s participation in contact sports.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Seruya M et al (2011) Long-term outcomes of primary craniofacial reconstruction for craniosynostosis: a 12-year experience. Plast Reconstr Surg 127(6):2397–2406

    Article  CAS  PubMed  Google Scholar 

  2. Panza MJ et al (2020) Adolescent sport participation and symptoms of anxiety and depression: a systematic review and meta-analysis. J Sport Exerc Psychol 42(3):201–218

    Article  PubMed  PubMed Central  Google Scholar 

  3. Vella SA et al (2014) Sports participation and parent-reported health-related quality of life in children: longitudinal associations. J Pediatr 164(6):1469–1474

    Article  PubMed  Google Scholar 

  4. MacIsaac ZM et al (2013) Nonfatal sport-related craniofacial fractures: characteristics, mechanisms, and demographic data in the pediatric population. Plast Reconstr Surg 131(6):1339–1347

    Article  CAS  PubMed  Google Scholar 

  5. Kim M, Moeller E, Thaller SR (2021) Sports-related craniofacial injuries among pediatric and adolescent females: a national electronic injury surveillance system database study. J Craniofac Surg 32(4):1603–1606

    Article  PubMed  Google Scholar 

  6. Stanuszek A et al (2021) Return to play after brain tumor surgery in children. Childs Nerv Syst 37(3):863–869

    Article  PubMed  Google Scholar 

  7. Miele VJ, Bailes JE, Martin NA (2006) Participation in contact or collision sports in athletes with epilepsy, genetic risk factors, structural brain lesions, or history of craniotomy. Neurosurg Focus 21(4):E9

    Article  PubMed  Google Scholar 

  8. Gilardino MS et al (2011) Does the incidence of traumatic brain injury in children increase after craniofrontal surgery? J Craniofac Surg 22(4):1284–1286

    Article  PubMed  Google Scholar 

  9. Yengo-Kahn AM et al (2021) Sport participation and related head injuries following craniosynostosis correction: a survey study. Neurosurg Focus 50(4):E15

    Article  PubMed  Google Scholar 

  10. Rotimi O et al (2021) Sporting activity after craniosynostosis surgery in children: a source of parental anxiety. Childs Nerv Syst 37(1):287–290

    Article  PubMed  Google Scholar 

  11. Rice SG, American Academy of Pediatrics Council on Sports and Fitness (2008) Medical conditions affecting sports participation. Pediatrics 121(4):841–8

    Article  PubMed  Google Scholar 

  12. Baker SR et al (2009) Coping strategies and social support in the family impact of cleft lip and palate and parents’ adjustment and psychological distress. Cleft Palate Craniofac J 46(3):229–236

    Article  PubMed  Google Scholar 

  13. Kuta V et al (2020) Understanding families’ experiences following a diagnosis of non-syndromic craniosynostosis: a qualitative study. BMJ Open 10(9)

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lattanzi W et al (2012) Genetic basis of single-suture synostoses: genes, chromosomes and clinical implications. Childs Nerv Syst 28(9):1301–1310

    Article  PubMed  Google Scholar 

  15. Nijhof SL et al (2018) Healthy play, better coping: the importance of play for the development of children in health and disease. Neurosci Biobehav Rev 95:421–429

    Article  PubMed  Google Scholar 

  16. Chieffo D et al (2010) Long-term neuropsychological development in single-suture craniosynostosis treated early. J Neurosurg Pediatr 5(3):232–237

    Article  PubMed  Google Scholar 

  17. Zerpe AS et al (2022) “When the surgery was over, I felt like the worst part had passed”: experiences of parents of children with craniosynostosis. J Spec Pediatr Nurs 27(2):e12370

    Article  PubMed  PubMed Central  Google Scholar 

  18. Park KE et al (2021) Neurological functional connectivity in unilateral coronal synostosis: a side-based comparison. J Craniofac Surg 32(3):910–914

    Article  PubMed  Google Scholar 

  19. Cousino MK, Hazen RA (2013) Parenting stress among caregivers of children with chronic illness: a systematic review. J Pediatr Psychol 38(8):809–828

    Article  PubMed  Google Scholar 

  20. Feragen KB, Stock NM (2017) Psychological adjustment to craniofacial conditions (excluding oral clefts): a review of the literature. Psychol Health 32(3):253–288

    Article  PubMed  Google Scholar 

  21. Nelson P et al (2012) Parents’ experiences of caring for a child with a cleft lip and/or palate: a review of the literature. Child Care Health Dev 38(1):6–20

    Article  CAS  PubMed  Google Scholar 

  22. Costa B et al (2023) Raising a child with craniosynostosis: psychosocial adjustment in caregivers. Cleft Palate Craniofac J 60(10):1284–1297

    Article  PubMed  Google Scholar 

  23. Saman Y et al (2012) Interactions between stress and vestibular compensation-a review. Front Neurol 3:116

    Article  PubMed  PubMed Central  Google Scholar 

  24. Conrad KL et al (2011) Stress-induced alterations in anxiety-like behavior and adaptations in plasticity in the bed nucleus of the stria terminalis. Physiol Behav 104(2):248–256

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Cardena E, Carlson E (2011) Acute stress disorder revisited. Annu Rev Clin Psychol 7:245–267

    Article  PubMed  Google Scholar 

  26. Needle JS, O’Riordan M, Smith PG (2009) Parental anxiety and medical comprehension within 24 hrs of a child’s admission to the pediatric intensive care unit. Pediatr Crit Care Med 10(6):668–674

    Article  PubMed  Google Scholar 

  27. Tremblay MS et al (2012) Canadian physical activity guidelines for the early years (aged 0–4 years). Appl Physiol Nutr Metab 37(2):345–369

    Article  PubMed  Google Scholar 

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Funding

No funding was received for conducting this study.

Author information

Author notes

  1. Neil Parikh and Kevin G. Hu are co-first authors.

Authors and Affiliations

  1. Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA

    Neil Parikh, Kevin G. Hu, Omar Allam, Jacqueline M. Ihnat, Albert L. Rancu, Sam Boroumand, John A. Persing & Michael Alperovich

Authors
  1. Neil Parikh
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  2. Kevin G. Hu
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  3. Omar Allam
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  4. Jacqueline M. Ihnat
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  5. Albert L. Rancu
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  6. Sam Boroumand
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  7. John A. Persing
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  8. Michael Alperovich
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Contributions

All authors contributed to the study conception and design. The material preparation, data collection, and analysis were performed by N.P. and K.G.H. The first draft of the manuscript was written by N.P., K.G.H., A.L.R., and O.A. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Michael Alperovich.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Yale University Institutional Review Board (HIC#: 2000030969).

Consent to participate

All patients and parents provided informed consent.

Conflict of interest

Dr. Alperovich receives funding from CTSA Grant Number KL2 TR001862 from the National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health (NIH) and consults for Johnson & Johnson and LifeNet Health. The manuscript contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH. The other authors have no financial interests to declare in relation to the content of this article.

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Parikh, N., Hu, K.G., Allam, O. et al. Sports participation after craniosynostosis repair: the critical role of post-operative guidance in parental decision-making. Childs Nerv Syst (2024). https://doi.org/10.1007/s00381-024-06381-0

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