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Jawad AM, Kadhum M, Evans J, Cubitt JJ, Martin N. Recovery of functional independence following major burn: A systematic review. Burns 2024; 50:1406-1423. [PMID: 38492981 DOI: 10.1016/j.burns.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/07/2024] [Accepted: 02/21/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Major burn injury, despite advancements in care and prevention, can have a profound impact on long-term morbidity, affecting quality of life and socioeconomic standing. We aim to explore factors predicting recovery of independence, the expected rate and time in majorly burned patients, and the measures of progress used. METHOD A systematic search of four databases (MEDLINE, EMBASE, COCHRANE, CINAHL) was conducted for studies reporting outcomes pertaining to physical ability indicative of independent function in adult (>15 y) cohorts who had suffered a major burn (>20% TBSA) up to 30 years after treatment in a developed specialised burn service. Data extracted included factors affecting rate of and time to achievement of function in five independence domains, as well as the outcome measures used. RESULTS 21 eligible studies were included comprising 1298 major burns survivors with a combined mean age of 39.6 y and a mean TBSA of 25.8%. The most significant recurring factors impacting recovery of independent function were older age, female gender, burn severity, prolonged ICU and hospital admission, preceding mental health conditions, and post-acute psychological issues. Exercise-based rehabilitation conferred benefits on major burn patients even over 2 years following injury. Discharge to independent living from hospital occurred in 27% to 97% of patients, while reported return to work rates varied from 52% to 80%. Burns Specific Health Scale-Brief, Functional Independence Measure, and Physical Composite Score (SF-36) were the most widely used outcome scoring systems. CONCLUSION Major burn survivors have protracted recovery with potential for persistent chronic impairments, remaining consistently below baseline levels of function. Non-modifiable factors such as age and gender, and disease characteristics such as burn size with associated physical, physiological and psychosocial sequelae are contributory. Further research is required to explore achievement of specific milestones of major burn and polytrauma critical care patients, while early targeted rehabilitation addressing physical, psychological, and vocational needs has promising potential benefit.
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Affiliation(s)
- Ali M Jawad
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK; Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK.
| | - Murtaza Kadhum
- Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK
| | - Janine Evans
- Welsh Centre for Burns and Plastic Surgery, Swansea, Wales, UK
| | | | - Niall Martin
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK
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Özdemir A, Yildiz Karadeniz E, Kaplan Serin E. Investigation of pre-discharge learning needs and affecting factors in individuals with burns. J Tissue Viability 2024:S0965-206X(24)00048-2. [PMID: 38622036 DOI: 10.1016/j.jtv.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/16/2024] [Accepted: 04/08/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND In discharge phase process, supporting patients to develop their own self-care strategies will increase their self-management skills and reduce complications and other health problems that may arise. AIM The aim of the study is to examine the learning needs of individuals with burns regarding pre-discharge care and treatment and the factors affecting them. METHOD Data from this cross-sectional study was collected with the "Descriptive Characteristics Form" and "Patient Learning Needs Scale (PLNS)". The study population consisted of patients hospitalized in the adult burn unit of a university hospital in eastern Turkey between May and October 2021. RESULTS In the present study, it was observed that the pre-discharge learning needs of the patients were at a high level according to the mean score of the general score of the PLNS. Education level, marital status, companion experience and body mass index effected PLNS. CONCLUSIONS In light of the results, it is recommended that discharge training be planned individually and determined according to the individual's learning needs and affecting factors.
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Affiliation(s)
- Ahmet Özdemir
- Kahramanmaraş Sütçü İmam University Faculty of Health Science, Kahramanmaraş, Turkey.
| | - Ebru Yildiz Karadeniz
- Mersin University Faculty of Nursing, Department of Fundamentals of Nursing, Mersin, Turkey.
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3
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Ebid AA, Attalla AF, Ibrahim AR, Mohamdy HM. Effect of anti-gravity treadmill (Alter G) training on gait characteristics and postural stability in adult with healed burns: A single blinded randomized controlled trial. Burns 2024; 50:106-114. [PMID: 37798213 DOI: 10.1016/j.burns.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/08/2023] [Accepted: 09/09/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Burns constitute one of the foremost contributors to premature mortality and morbidity, and the recovery process from burn injuries is characterized by its intricate and protracted nature. OBJECTIVE The principal aim of this study was to assess the influence of an anti-gravity treadmill (Alter G) training program on both gait characteristics and postural stability indices (PSI) in adult individuals who have recovered from burns. DESIGN This study followed a single-blind, randomized, controlled design. METHODS A total of 45 adults, aged 18-35 years, with healed lower extremity burns that were circumferential and encompassed 35-50% of their total body surface area (TBSA) were randomly allocated to either the anti-gravity treadmill (Alter G) Training group (n = 22) or the traditional physical therapy program (TPTP) group (n=23). The TPTP group received conventional physical therapy, while the anti-gravity treadmill (Alter G) training group engaged in anti-gravity treadmill exercises alongside the traditional physical therapy program. The primary outcome measures, evaluated at both baseline and the conclusion of the 12-week intervention, included gait characteristics assessed using the GAITRite system and PSI measured by the Biodex Balance System (BBS). RESULTS The anti-gravity treadmill (Alter G) training group exhibited significantly greater enhancements than the TPTP group in terms of mean values and percentage changes in gait characteristics and PSI. Specifically, the percentage changes for the Alter G group were as follows: stride length (20.57%), step time (22.58%), step length (20.47%), velocity (15.67%), cadence (23.28%), and double support time (29.03%). In contrast, the TPTP group's percentage changes were: 6.73%, 8.19%, 7.65%, 7.75%, 8.89%, and 9.37%, respectively. Concerning PSI, the Alter G group exhibited percentage changes of 55.17% for the medio-lateral stability index (MLI), 48.21% for antero-posterior stability index (API), and 48.48% for the overall stability index (OSI). The TPTP group's corresponding percentage changes were 20%, 14.03%, and 16.41%. CONCLUSIONS The amalgamation of anti-gravity treadmill training with the traditional physical therapy program yields greater efficacy than TPTP in isolation. Consequently, the findings underscore the efficiency of anti-gravity treadmill (Alter G) Training as a valuable tool for rehabilitating patients with burn injuries.
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Affiliation(s)
| | - Asmaa Fawzy Attalla
- Department of Surgery, Faculty of Physical Therapy, Cairo University, Giza Egypt
| | - Abeer Ramadan Ibrahim
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Heba Mohamed Mohamdy
- Department of Surgery, Faculty of Physical Therapy, Cairo University, Giza Egypt
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Rivas E, Foster J, Crandall CG, Finnerty CC, Suman-Vejas OE. Key Exercise Concepts in the Rehabilitation from Severe Burns. Phys Med Rehabil Clin N Am 2023; 34:811-824. [PMID: 37806699 PMCID: PMC10731385 DOI: 10.1016/j.pmr.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
This article presents information on the benefits of exercise in counteracting the detrimental effects of bed rest, and/or severe burns. Exercise is key for maintaining physical function, lean body mass, metabolic recovery, and psychosocial health after major burn injuries. The details of an exercise training program conducted in severely burned persons are presented, as well as information on the importance of proper regulation of body temperature during exercise or physical activity. The sections on exercise and thermoregulation are followed by a section on the role of exercise in scarring and contractures. Finally, gaps in the current knowledge of exercise, thermoregulation, and contractures are presented.
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Affiliation(s)
- Eric Rivas
- Microgravity Research, In-Space Solutions, Axiom Space Headquarters, 1290 Hercules Avenue, Houston, TX 77058, USA
| | - Josh Foster
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Institute for Exercise and Environmental Medicine (IEEM), Texas Health Presbyterian Hospital Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Craig G Crandall
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Institute for Exercise and Environmental Medicine (IEEM), Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Suite 435, Dallas, TX 75231, USA
| | - Celeste C Finnerty
- Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1220, USA
| | - Oscar E Suman-Vejas
- Department of Surgery, Division of Surgical Sciences, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1220, USA.
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Khanipour M, Lajevardi L, Taghizadeh G, Azad A, Ghorbani H. Effects of an Occupation-Based Intervention on Hand and Upper Extremity Function, Daily Activities, and Quality of Life in People With Burn Injuries: A Randomized Controlled Trial. Am J Occup Ther 2023; 77:7705205090. [PMID: 37851587 DOI: 10.5014/ajot.2023.050115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
IMPORTANCE Occupational performance and function are affected in people with burn injuries to the hand and upper extremity; this can lead to the development of some disabilities and endanger quality of life. OBJECTIVE To investigate the effects of occupation-based intervention on hand and upper extremity function, daily activities, and quality of life in people with burn injuries. DESIGN Randomized controlled trial. SETTING Specialized burn hospital in Iran. PARTICIPANTS Patients (N = 20) with burn injuries to the hand and upper extremity. INTERVENTIONS The control group received only traditional rehabilitation, and the intervention group received traditional rehabilitation and took part in the Cognitive Orientation to daily Occupational Performance (CO-OP) protocol (18 sessions, 45 min/day, for both groups). MEASURES Assessments included the CO-OP; Michigan Hand Outcomes Questionnaire; Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire; Modified Barthel Index; World Health Organization Quality-of-Life Scale-Brief; a visual analogue scale; measurements with a goniometer and dynamometer; and the figure-of-eight method. These evaluations were conducted with both groups before the rehabilitation program commenced and at Wk 2, 6, and 14 (follow-up). RESULTS The results showed that there were notable changes in all the study variables except edema in both groups. However, these changes (p [V] ≤ .05) were not statistically significant between the two groups. CONCLUSIONS AND RELEVANCE According to the results, the occupation-based interventions are as effective as traditional therapeutic interventions for the improvement of hand and upper extremity function, ability to perform daily activities, and quality of life in people with burn injuries. What This Article Adds: The CO-OP protocol, as an occupation-based intervention, can improve hand performance, ability to perform daily activities, and quality of life in people with burn injuries, and thus it can be useful in rehabilitation clinics.
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Affiliation(s)
- Mahnoosh Khanipour
- Mahnoosh Khanipour, MSc, is Instructor, Department of Occupational Therapy, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Islamic Republic of Iran;
| | - Laleh Lajevardi
- Laleh Lajevardi, PhD, is Associate Professor, Department of Occupational Therapy, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Ghorban Taghizadeh
- Ghorban Taghizadeh, PhD, is Associate Professor, Department of Occupational Therapy, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Akram Azad
- Akram Azad, PhD, is Associate Professor, Department of Occupational Therapy, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hooman Ghorbani
- Hooman Ghorbani, MSc, is Occupational Therapy Practitioner, Department of Occupational Therapy, Shahid Motahhari Specialized Burn Hospital, Tehran, Islamic Republic of Iran
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Zal M, Deldar K, Froutan R, Ahmadabadi A, Mazlom SR. Rehabilitation of Burn Victims: Improving Quality of Life in Victims With Face and Neck Burn Through an Augmented Reality Coupled Pamphlet. J Burn Care Res 2023; 44:311-319. [PMID: 35603694 DOI: 10.1093/jbcr/irac070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Indexed: 11/14/2022]
Abstract
The present study aimed to investigate the effect of implementing rehabilitation programs using an augmented reality (AR) coupled pamphlet on the quality of life (QOL) of patients with face/neck burns. This randomized clinical trial was conducted on 60 patients (intervention = 30, control = 30) admitted to the burn center of Imam Reza Hospital, Mashhad, Iran. Patients in the intervention group performed their rehabilitation program using AR coupled pamphlet during 6 weeks, while control patients used simple pamphlet. The Burn-Specific Health Scale for Face and Neck (BSHS-FN) was completed at the beginning, and 2 and 6 weeks after the intervention. The results for 2 weeks after intervention measures in model 1 ANCOVA showed significant raise of measures only for Hand function (P = .035). However, for the total QOL score and other domains the differences were not significant (All P > .05). Adjusting for confounders, model 2 ANCOVA showed similar results for 2 weeks after intervention. However, in both models, the results indicated significant intervention effect for 6 weeks after intervention in QOL score and all domains (All P < .05), so that the amount of increase in measures were significantly higher in the intervention group. According to the findings, implementing rehabilitation program for patients with face and neck burns using AR coupled pamphlet can improve their QOL.
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Affiliation(s)
- Masoumeh Zal
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kolsoum Deldar
- Department of Information Technology, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Sharoud, Iran
| | - Razieh Froutan
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Iran.,Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Iran
| | - Ali Ahmadabadi
- Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Iran
| | - Seyed Reza Mazlom
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Iran
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Plaza A, Paratz J, Cottrell M. A six-week physical therapy exercise program delivered via home-based telerehabilitation is comparable to in-person programs for patients with burn injuries: A randomized, controlled, non-inferiority clinical pilot trial. Burns 2023; 49:55-67. [PMID: 36115795 DOI: 10.1016/j.burns.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 07/13/2022] [Accepted: 08/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Exercise programmes are essential for burn rehabilitation, however patients often have barriers accessing these services. Home-based telerehabilitation (HBT) may be an alternative. This study aimed to determine if exercise programs delivered via HBT were as effective as in-person (IP) programs with respect to clinical outcomes and participant and therapist satisfaction. METHODS A single center, randomized, controlled, non-inferiority pilot trial with blinded assessment was undertaken. Forty-five adults with ≤ 25% total body surface area (TBSA) burns were randomized to receive a 6-week exercise program delivered either by HBT or IP. The primary outcome was burn-specific quality of life (Burn Specific Health Scale - Brief). Secondary outcomes included health-related quality of life, burn scar-specific outcomes, exercise self-efficacy, pain severity, muscle strength and range of motion (ROM). Participant and therapist satisfaction, technical disruptions and adverse events were also recorded. RESULTS We found no significant within- or between-group differences for any outcome measures except ROM. Achievement of full ROM was significantly different between groups at Week 12 (IP=100% vs HBT=70%, p = 0.005). Non-inferiority was inconclusive. Participant satisfaction was high (median ≥ 9.8/10), with no significant between-group differences. Therapist satisfaction was high (median ≥ 8.9/10), major technical disruptions low (8%) and no adverse events reported. CONCLUSION HBT is a safe, effective option to deliver exercise programs for patients with burn injuries ≤ 25% TBSA with comparable clinical outcomes to in-person programmes. Ongoing research is required to further analyze ROM and investigate the effectiveness of HBT for patients with larger burns.
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Affiliation(s)
- Anita Plaza
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD 4029, Australia; Professor Stuart Pegg Adult Burn Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia.
| | - Jennifer Paratz
- Physiotherapy Department, Griffith University, Brisbane, QLD 4222, Australia
| | - Michelle Cottrell
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD 4029, Australia
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Abd El Aziz WAEA, Borhan WH, Ashem HN, Mohammed AES. Adjunctive effect of pulsed electromagnetic field therapy on quadriceps muscle strength after burn injury. FIZJOTERAPIA POLSKA 2022; 22:122-127. [DOI: 10.56984/8zg1a6zsv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Purpose. This study was conducted to examine the effect of pulsed electromagnetic field therapy on quadriceps muscle strength after burn injury. Methods. From April 2021 to June 2022, sixty male patients who suffered from second degree lower limb thermal burn injury and Total body surface area (TBSA) from 25% to 35% participated in this study. Their ages ranged from (20-40) years. They were randomly assigned in two groups, a study group composed of 30 patients who received (PEMF) over thigh area before strengthening exercise for quadriceps muscle and a control group composed of 30 patients who received strengthening exercise for quadriceps muscle. Patients of both groups received traditional physical therapy program.. Evaluation tool was isokinetic dynamometer to measure the quadriceps muscle peak torque before the treatment and after 8 weeks of treatment for both groups. Results. There was no significant difference between both group (study and control) in mean values of quadriceps peak torque pre-treatment (P > 0.05). There was a significant increase in the mean values of quadriceps peak torque after 8 weeks of treatment in both groups (p < 0.05) while there was a significant difference in post treatment mean values of quadriceps peak torque in the study group when compared with control group (p < 0.05). Conclusion. Pulsed electromagnetic field therapy is an effective modality that can be used for improving muscle strength and performance in patients with lower limb burn when applied prior to strengthening exercise.
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Affiliation(s)
| | - Wafaa Hussein Borhan
- Surgery and Burns Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Haidy Nady Ashem
- Surgery and Burns Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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Edger-Lacoursière Z, Deziel E, Nedelec B. Rehabilitation interventions after hand burn injury in adults: A systematic review. Burns 2022; 49:516-553. [PMID: 35662480 DOI: 10.1016/j.burns.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/15/2022]
Abstract
The aim of this review was to summarise the current evidence regarding the effectiveness of rehabilitation interventions in improving hand function, range of motion (ROM), hand strength, scar outcome, return to work, level of impairment/disability, level of burn knowledge and decreasing edema following hand burns in adult burn survivors. This review provides evidence-based support for the use of rehabilitation interventions for burn rehabilitation professionals. The following data sources were searched: MEDLINE, EMBASE and CINAHL from their inception up to February 2021, reference lists from all the included full-text articles were screened for additional relevant publications and monthly Google Scholar searches until December 23rd 2021 to make sure all new pertinent published articles after February 2021 would be included. Thirty-five studies were included in this review including 14 RCTs. Most of the included studies were Level 4 (46%; 16/35) and Level 2 (40%; 14/35) evidence. Only four studies were classified as Level 3 (14%; 5/35) evidence and none were considered Level 1. Most studies received a score of 5-9 (54%; 19/35) (Moderate quality). Fourteen studies received a score of ≥ 10 (40%; 14/35) (High quality) and only 2 studies received a score of< 5 (6%; 2/35) (Low quality). Articles were categorized according to the primary outcome targeted by the intervention. Clinical recommendations on higher-level evidence interventions are presented. This review supports the clinical practice of the following interventions: 1) The use of adhesive compression wraps for patients who have increased edema to increase hand function and ROM; 2) The use of compression (adhesive compressive wrap, compression bandage or intermittent compression pump) to decrease hand edema following burn injury; 3) Participating in general rehabilitation to increase hand function and patient perceived level of disability; 4) The use of an orthosis to increase ROM and a dynamic MCP orthosis to increase hand function; 5) If available, incorporate the use of VR based rehabilitation to increase hand function and hand strength; 6) The use of paraffin to increase hand PROM; 7) The use of gels to reduce hand scar thickness; 8) The use of an education component in rehabilitation to increase the level of burn knowledge. The limitations of this study are also discussed. Further research with robust methodology is needed to investigate the potential benefits of treatment interventions included in this review.
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Affiliation(s)
- Zoë Edger-Lacoursière
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3A 0G4, Canada; Hôpital de Réadaptation Villa Medica, Montreal, QC H2X 1C9, Canada; Centre Professionnel d'Ergothérapie, Montreal, QC H1N 1E5, Canada
| | - Erika Deziel
- Centre Professionnel d'Ergothérapie, Montreal, QC H1N 1E5, Canada
| | - Bernadette Nedelec
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3A 0G4, Canada; Hôpital de Réadaptation Villa Medica, Montreal, QC H2X 1C9, Canada.
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10
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Jeong WJ, Holavanahalli RK, Kowalske KJ. Evaluation of Kinesiophobia in Survivors of Major Burn Injury. J Burn Care Res 2022; 43:1380-1385. [PMID: 35385580 DOI: 10.1093/jbcr/irac043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Kinesiophobia, the fear of movement and re-injury, has not been described in burn injury survivors. Physical activity is a key component of burn rehabilitation programs. Yet, not all burn survivors exercise at the recommended level. This is an exploratory study examining the association of the demographics and injury characteristics of burn survivors with a fear of movement. The subjective fear of movement was measured using the Tampa Scale for Kinesiophobia (TSK). The TSK score was compared between several demographics and injury characteristics by performing the independent sample t-test. Sixty-six percent of subjects in our study (n=35), reported high levels of kinesiophobia (score 37 or above). The mean scores of the TSK were greater in males (40.7), non-White (43.0), Hispanic/Latino (41.1), age greater than 50 years (42.3), and total body surface area (TBSA) burn of >15% compared to females (36.9), White (38.5), non-Hispanic/Latino (39.3), age 50 years or less (38.1), and TBSA 15% or less (39.4) respectively. However, with the exception of time post injury, none of the mean differences were statistically significant. Subjects who had sustained a burn injury more than 12 months ago showed higher levels of kinesiophobia than the subjects who were injured within 12 months with a mean difference of 7.35 (p=.01). Thus, this study highlights the importance of (i) continued, long-term follow up for burn survivors, and (ii) appropriate educational and treatment interventions to address any underlying existing, new, or emerging medical issues that may contribute to the fear or avoidance of movement.
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Affiliation(s)
- Won J Jeong
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, U.S.A
| | - Radha K Holavanahalli
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, U.S.A
| | - Karen J Kowalske
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, U.S.A
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Abstract
ABSTRACT Management of the metabolic responses to severe burn injury is recognized as a fundamental part of burn care. Definition of burn hypermetabolism is being refined to subcellular and genomic levels, and treatment concepts are need to be refined into increasingly sophisticated strategies.
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Affiliation(s)
- David Herndon
- From the Joseph M. Still Research Foundation, Inc., Augusta, GA
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12
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Graded aerobic exercise (GAEx): An effective exercise regimen to improve cardio-respiratory fitness and physical and psychosocial functioning in children with burn sequelae of the chest. Burns 2022; 48:337-344. [PMID: 34016485 DOI: 10.1016/j.burns.2021.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE The cardio-respiratory function is compromised in children recovering from burns, particularly, those who sustain a burn injury across the chest, which leads to further prejudicial effects on physical and psychosocial health. This study endeavored to explore the efficacy of 12 weeks of graded aerobic exercise (GAEx) on the cardiorespiratory capacity and physical and psychosocial functioning in children with burn sequelae of the chest. METHODS Thirty-six burn-injured children aged 10-18 years (%TBSA: 24.2 ± 4.9, and 38.8 ± 12.9 months since injury) were randomly assigned to GAEx group (n = 18; undergone a 12-week intensity- and time-graded aerobic exercise program plus standard rehabilitation) or control group (n = 18; received the standard rehabilitation only). The cardio-respiratory fitness [marked by the peak oxygen uptake (VO2peak), minute ventilation (VE), ventilatory equivalent of inhaled oxygen (VEq/VO2), oxygen pulse (O2P), respiratory exchange ratio (RER), maximum heart rate (HRmax), and the heart rate recovery at one minute (HRR1)] and physical and psychosocial functioning were assessed pre- and post-intervention. RESULTS Children in the GAEx group showed significant increases in VO2peak (P = 0.013), VE (P = 0.026), O2P (P = 0.034), HRmax (P = 0.035), and HRR1 (P = 0.04) and declines in VEq/VO2 (P = 0.009) and RER (P = 0.011) as compared to the control group. Additionally, the GAEx group reported higher physical (P = 0.029) and psychosocial (P = 0.012) functioning. CONCLUSION Twelve weeks of GAEx has salutary effects on cardio-respiratory capacity and physical and psychosocial functioning in children with burn sequelae of the chest. These findings suggest that adding GAEx as a complementary therapy to the long-term rehabilitation protocol for this patient population is worthwhile.
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13
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Plaza A, Adsett J, Byrnes A, McRae P. Physical activity levels in hospitalised adults with burn injuries. J Burn Care Res 2021; 43:1048-1054. [PMID: 34878542 DOI: 10.1093/jbcr/irab233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Physical activity behaviour has not been previously described in hospitalised adults with burn injuries. This prospective, cross-sectional study used a standardised behavioural mapping protocol to observe patient behaviour related to physical activity over a 12-hour period on one weekday in a quaternary referral specialist burn centre. Structured observations were recorded for each of four domains: 1) patient location, 2) position, 3) activity performed and 4) the presence of others. Observations were summarised across all participants as median (IQR) proportion of time. Participants (n=17) were predominantly male (82%) with a mean age of 44.3 (SD 15.2) years, a mean burn size of 34.9% (SD 26.7) total body surface area and a median hospital length of stay of 18 (IQR 6-49) days at time of observation. Participants spent a median of 83% (IQR 73-93) of time in their bedroom, 92% (IQR 68-97) of time in or on their bed and a median of 5% (IQR 3-13) of time mobilising. Exercise accounted for 10% (IQR 8-17) of activity related observations. A median of 68% (IQR 39-83) of time was spent alone. Results suggest time spent engaging in physical activity is low. Further studies are required to investigate motivators and barriers to performing physical activity in this population. This will consequently inform the development and implementation of appropriate strategies to improve physical activity behaviour in this cohort.
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Affiliation(s)
- Anita Plaza
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.,Professor Stuart Pegg Adult Burn Centre, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia
| | - Julie Adsett
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia
| | - Angela Byrnes
- Internal Medicine Research Unit, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia
| | - Prue McRae
- Internal Medicine Research Unit, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia
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14
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Bayuo J, Wong FKY. Intervention Content and Outcomes of Postdischarge Rehabilitation Programs for Adults Surviving Major Burns: A Systematic Scoping Review. J Burn Care Res 2021; 42:651-710. [PMID: 32608488 DOI: 10.1093/jbcr/iraa110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Improvement in burn care has led to more patients surviving the injury but has also led to more burn survivors requiring rehabilitation for a protracted period after discharge. Thus, this review sought to map the intervention content and outcomes associated with existing postdischarge rehabilitation programs for adults surviving major burns. A systematic scoping review approach was utilized. The Template for Intervention Description and Replication (TIDieR) and core outcome set for adult burn survivors were used to guide data extraction following which a narrative synthesis was undertaken. In all, 23 papers were retained in the review. Following discharge and up to 1 year postburn, the components of the rehabilitation programs comprised of physical, psychological, and social components. Beyond 1 year postburn, the rehabilitation programs demonstrated a preponderance of physical therapies. Support for family members was not highlighted in the included studies. Outcomes of rehabilitation programs up to 1 year postburn covered the seven core outcome domains. Outcomes associated with rehabilitation programs beyond 1 year postburn were, however, limited to the perceived quality of life, neuromuscular, and physical role functioning domains. Although most studies reported statistically significant findings, the outcome measures varied across studies which makes it difficult to draw overarching conclusions. The findings suggest that long-term rehabilitation programs for adult burn survivors are lacking. More robust studies are also needed to examine community participation outcomes associated with burns rehabilitation programs. The nature of burns and its far-reaching consequences suggest a patient- and family-centered approach to rehabilitation.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
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15
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Palackic A, Suman OE, Porter C, Murton AJ, Crandall CG, Rivas E. Rehabilitative Exercise Training for Burn Injury. Sports Med 2021; 51:2469-2482. [PMID: 34339042 DOI: 10.1007/s40279-021-01528-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
Due to improvements in acute burn care over the last few decades, most patients with severe burns (up to 90% of the total body surface) survive. However, the metabolic and cardiovascular complications that accompany a severe burn can persist for up to 3 years post injury. Accordingly, there is now a greater appreciation of the need for strategies that can hasten recovery and reduce long-term morbidity post burn. Rehabilitation exercise training (RET) is a proven effective treatment to restore lean body mass, glucose and protein metabolism, cardiorespiratory fitness, and muscle strength in burn survivors. Despite this, very few hospitals incorporate RET in programs to aid the rehabilitation of patients with severe burns. Given that RET is a safe and efficacious treatment that restores function and reduces post-burn morbidity, we propose that a long-term exercise prescription plan should be considered for all patients with severe burns. In this literature review, we discuss the current understanding of burn trauma on major organ systems, and the positive benefits of incorporating RET as a part of the long-term rehabilitation of severely burned individuals. We also provide burn-specific exercise prescription guidelines for clinical exercise physiologists.
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Affiliation(s)
- Alen Palackic
- Department of Surgery, Division of Surgical Sciences, Medical Branch, University of Texas, Galveston, TX, USA.,Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Oscar E Suman
- Department of Surgery, Division of Surgical Sciences, Medical Branch, University of Texas, Galveston, TX, USA
| | - Craig Porter
- Department of Pediatrics, Division of Developmental Nutrition, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Andrew J Murton
- Department of Surgery, Division of Surgical Sciences, Medical Branch, University of Texas, Galveston, TX, USA
| | - Craig G Crandall
- Southwestern Medical Center, University of Texas, Dallas, TX, USA
| | - Eric Rivas
- KBR, Human Physiology, Performance, Protection and Operations Laboratory, NASA Johnson Space Center, 2101 NASA Parkway, Houston, TX, 77058, USA.
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16
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Froutan R, Saberi A, Ahmadabadi A, Mazlom SR. The Effect of a Recreational Therapy Program on the Pain Anxiety and Quality of Life of Patients with Burn Injuries: A Randomized Clinical Trial. J Burn Care Res 2021; 43:381-388. [PMID: 34329456 DOI: 10.1093/jbcr/irab153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Pain anxiety and dysfunction are among the most prevalent complications of burns, impacting the quality of life of patients with burn injuries. As a non-pharmaceutical approach, recreational therapy can be effective in reducing the complications of burns. This study aimed to examine the effect of a recreational therapy program on the pain anxiety and quality of life of patients with burn injuries. This controlled randomized clinical trial was conducted on 58 patients admitted to the burn center of XXX. These patients were randomly allocated to the intervention and control group. The intervention group received a recreational therapy program three sessions a week, for two weeks. The control group performed routine daily activities. As the main variable of the study, the Burn Specific Pain Anxiety Scale and Burn Specific Health Scale-Brief were completed for both groups before and two weeks after the intervention. After controlling confounders, the pain anxiety score in the intervention group was significantly lower than in the control group (p = 0.002). The total quality of life score was significantly higher in the intervention group than the control group (p = 0.001). In addition, the intervention significantly increased the scores of quality of life in the physical (p< 0.001), emotional (p = 0.009), and social (p< 0.001) dimensions. As it reduces pain anxiety and promotes the quality of life of patients with burn injuries, this recreational therapy program is recommended for promoting the mental health and quality of life of these patients.
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Affiliation(s)
- Razieh Froutan
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran / Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Saberi
- Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Ahmadabadi
- Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Reza Mazlom
- Instructor of Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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17
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Basha MA, Aboelnour NH, Aly SM, Kamel FAH. Impact of Kinect-based virtual reality training on physical fitness and quality of life in severely burned children: a monocentric randomized controlled trial. Ann Phys Rehabil Med 2020; 65:101471. [PMID: 33316436 DOI: 10.1016/j.rehab.2020.101471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/02/2020] [Accepted: 11/18/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pediatric burns lead to persistent and detrimental muscle breakdown, weakness and poor quality of life, so rehabilitation is integral for improving physical and psychological outcomes. However, children with burns are a major challenge to a rehabilitation team. To overcome these challenges, enjoyable and interesting interventions are suggested. OBJECTIVE We aimed to determine the impact of the Xbox Kinect on cardiopulmonary fitness, muscle strength, lean mass, quality of life and enjoyment in severely burned children after hospital discharge. METHODS This was a randomized controlled trial in a single centre. Participants (n= 40 children) with burn injuries were randomized to the Xbox training group (n=20) or control group (n=20) during 12 weeks. All children received a home programme rehabilitation and Xbox training children received Xbox training. Outcomes included cardiopulmonary fitness (VO2peak), muscle strength (peak torque), lean mass (whole-body and regional), quality of life and physical activity enjoyment at baseline, immediately after hospital discharge, and 12 weeks after the intervention. RESULTS The mean (SD) age of the 40 children was 12.97 (1.42) years and total body surface area of burn was 51% (5). The groups did not differ in characteristics at baseline (P < 0.05). After 12 weeks of the intervention, the groups significantly differed in VO2peak, peak torque, quality of life (p<0.001), lean mass and leg lean mass (p<0.05) in favour of Xbox training. The mean difference in VO2peak, peak torque, lean mass and leg lean mass was 3.25 (2.1; 4.5) ml/kg/min, 7.5 (5.8; 9.2) Nm, 1.81 (0.5; 3.1) kg, and 1.1 (0.1; 2.1) kg, respectively. Lean trunk mass did not significantly differ between groups (p=0.07). The Xbox training group reported significantly more enjoyment than did the control group (p<0.001). CONCLUSION Xbox Kinect training can increase cardiopulmonary fitness, muscle strength, lean mass and quality of life in burned children. It is one of the most enjoyable, motivated and efficient treatment modalities that should be widely introduced into the pediatric burn rehabilitation.
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Affiliation(s)
- Maged A Basha
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraidah, Qassim, Saudi Arabia; Department of Physical Therapy, ElSahel Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt.
| | - Nancy H Aboelnour
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Sobhy M Aly
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Fatma Alzahraa H Kamel
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraidah, Qassim, Saudi Arabia; Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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18
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Gittings PM, Wand BM, Hince DA, Grisbrook TL, Wood FM, Edgar DW. The efficacy of resistance training in addition to usual care for adults with acute burn injury: A randomised controlled trial. Burns 2020; 47:84-100. [PMID: 33280953 DOI: 10.1016/j.burns.2020.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/13/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
Resistance training immediately after a burn injury has not been investigated previously. This randomised, controlled trial assessed the impact of resistance training on quality of life plus a number of physical, functional and safety outcomes in adults with a burn injury. Patients were randomly assigned to receive, in addition to standard physiotherapy, four weeks of high intensity resistance training (RTG) or sham resistance training (CG) three days per week, commenced within 72h of the burn injury. Outcome data was collected at six weeks, three and six months after burn injury. Quality of life at 6 months was the primary endpoint. Data analysis was an available cases analysis with no data imputed. Regression analyses were used for all longitudinal outcome data and between-group comparisons were used for descriptive analyses. Forty-eight patients were randomised resistance training (RTG) (n=23) or control group (CG) (n=25). The RTG demonstrated improved outcomes for the functional domain of the Burn Specific Health Scale-Brief (p=0.017) and the Quick Disability of Arm Shoulder and Hand (p<0.001). Between group differences were seen for C-reactive protein and retinol binding protein (p=0.001). Total quality of life scores, lower limb disability, muscle strength and volume were not seen to be different between groups (p>0.05). Resistance training in addition to usual rehabilitation therapy showed evidence of improving functional outcomes, particularly in upper limb burn injuries. Additionally, resistance training commenced acutely after a burn injury was not seen to be harmful to patients.
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Affiliation(s)
- Paul M Gittings
- State Adult Burns Service, South Metropolitan Area Health Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; School of Physiotherapy, University of Notre Dame Australia, Fremantle, Western Australia, Australia; Fiona Wood Foundation, Murdoch, Western Australia, Australia.
| | - Benedict M Wand
- School of Physiotherapy, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Dana A Hince
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Tiffany L Grisbrook
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia
| | - Fiona M Wood
- State Adult Burns Service, South Metropolitan Area Health Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Murdoch, Western Australia, Australia; Burn Injury Research Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | - Dale W Edgar
- State Adult Burns Service, South Metropolitan Area Health Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Murdoch, Western Australia, Australia; Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia; Burn Injury Research Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia; Burn Injury Research Node, Institute of Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
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19
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Huang M, Moralez G, Romero SA, Jaffery MF, Cramer MN, Petric JK, Nabasny AD, Crandall CG. The benefits of an unsupervised exercise program in persons with well-healed burn injuries within the International Classification of Functioning, Disability and Health (ICF). Burns 2020; 46:1280-1288. [PMID: 32660830 DOI: 10.1016/j.burns.2020.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
Vast improvements in the survival rates following burn injuries has led to a greater number of patients living with a wide range of long-term impairments, activity limitations, and participation constraints. Therefore, long-term care is critical in this clinical population and necessitates appropriate rehabilitation strategies to maximize an individual's overall health. The purpose of this study was to test the hypothesis that the extent to which outcomes within the International Classification of Functioning, Disability, and Health (ICF) framework are improved following 6 months of unsupervised exercise training is influenced by the severity of a burn injury (i.e., percent body surface area injured). Outcome variables representing the dimensions of the ICF, body functions & structure, activity, and participation, were collected pre- and post- 6 months of exercise training in three groups of participants: non-injured control subjects (N = 11), subjects with moderate-level well-healed burn injuries (N = 13, 26 ± 6% body surface area burned), and subjects with high-level well-healed burn injuries (N = 20, 58 ± 15% body surface area burned). Exercise training improved lower extremity strength (changes in peak torque/kg body mass at 90 degrees/sec flexion: 30 ± 5% and extension: 36 ± 4%, p < 0.05) and functional activities (changes in sit to stand: -9 ± 4% and ascend stairs: -4 ± 1%; p < 0.05) in all groups. For outcome variables representing ICF levels of body functions & structure and activity, there were no differences at baseline or improvements made between the groups after training. That said, with the exception of the domain of functional activity (reported 17 ± 34% improvement in the high-level burn cohort, p < 0.05), no changes were revealed in the participation level of ICF indexed by health-related quality of life questionnaires. These findings support the utilization of a 6-month unsupervised exercise training program in the long-term rehabilitation of individuals with burn injuries; that is, improvements in body functions & structure and activity can be achieved with an exercise regimen regardless of the severity of burn injury.
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Affiliation(s)
- Mu Huang
- University of Texas Southwestern Medical Center and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, USA; University of Texas Southwestern Medical Center School of Health Professions, Dallas, TX, USA
| | - Gilbert Moralez
- University of Texas Southwestern Medical Center and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, USA; University of Texas Southwestern Medical Center School of Health Professions, Dallas, TX, USA
| | - Steven A Romero
- University of Texas Southwestern Medical Center and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, USA; University of North Texas Health Science Center, Ft. Worth, TX, USA
| | - Manall F Jaffery
- University of Texas Southwestern Medical Center and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, USA
| | - Matthew N Cramer
- University of Texas Southwestern Medical Center and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, USA
| | - Jan Karel Petric
- University of Texas Southwestern Medical Center School of Health Professions, Dallas, TX, USA
| | - Andrew D Nabasny
- University of Texas Southwestern Medical Center School of Health Professions, Dallas, TX, USA
| | - Craig G Crandall
- University of Texas Southwestern Medical Center and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, USA.
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20
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Langlois J, Vincent-Toskin S, Duchesne P, Soares de Vilhena B, Shashoua D, Calva V, de Oliveira A, Nedelec B. Fear avoidance beliefs and behaviors of burn survivors: A mixed methods approach. Burns 2020; 47:175-189. [PMID: 33303261 DOI: 10.1016/j.burns.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
The Fear-Avoidance Model was developed with patients who had sustained neck and back injuries and describes a cascade of events after pain that is perceived as threatening, which may lead to avoidance of valued and meaningful life activities. The literature examining burn survivors suggests they may experience fear-avoidance, however, their lived experience has yet to be thoroughly explored and the evaluation tool that has been used is four items extracted from the Tampa Scale of Kinesiophobia that were modified for burn survivors, but never formally validated with this population. Therefore, the aim of this study was to explore, through a mixed methods approach, the lived experience of burn survivors with respect to fear-avoidance and determine whether the reduced four question Tampa Scale of Kinesiophobia (4TSK) reflects and accurately measures their experience. Burn survivors (n = 17) who had undergone surgical debridement and grafting were recruited. They completed the reduced 4TSK and participated in an in-depth interview to explore their lived experience regarding fear-avoidance and their opinions on the relevance of the questions. The interviews were analyzed using a thematic-analysis approach. Five major themes that represented the lived experience of fear-avoidance in burn survivors were identified: perceived vulnerability to re-injury, others as fear influencers, difficulties & hardships during recovery, engagement in activity, and active thoughts. Based upon the interviews researchers identified 9 potential fear-avoidant participants, which differed from the screening results from the reduced 4TSK (n = 12). Overall, this study demonstrated the potential uniqueness of the burn survivor population and provided insight into their lived experience of fear of movement or activities.
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Affiliation(s)
- Jade Langlois
- School of Physical and Occupational Therapy, McGill University, Canada
| | | | - Philippe Duchesne
- School of Physical and Occupational Therapy, McGill University, Canada
| | | | | | - Valérie Calva
- Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
| | - Ana de Oliveira
- Centre de recherche, Center hospitalier de l'Université de Montréal (CRCHUM), Canada
| | - Bernadette Nedelec
- School of Physical and Occupational Therapy, McGill University, Canada; Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada; Centre de recherche, Center hospitalier de l'Université de Montréal (CRCHUM), Canada.
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21
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Polychronopoulou E, Herndon DN, Porter C. The Long-Term Impact of Severe Burn Trauma on Musculoskeletal Health. J Burn Care Res 2020; 39:869-880. [PMID: 30010999 DOI: 10.1093/jbcr/iry035] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/15/2018] [Indexed: 12/13/2022]
Abstract
Severe burn injury causes a profound stress response that leads to muscle and bone cachexia. Evidence suggests that these deficits persist for several months or even years after injury and are associated with growth delay, increased incidence of fractures, and increased hospital admissions for musculoskeletal disorders. Thus, there is an overwhelming need to determine the optimal acute and rehabilitative strategies to mitigate these deficits and improve quality of life for burn survivors. To date, there is limited research on the long-term impact of cachexia on functional performance and overall health, as well as on the lasting impact of pharmacological, nutritional, and exercise interventions. The aim of this review is to emphasize the long-term consequences of musculoskeletal cachexia and determine the best evidence-based strategies to attenuate it. We also underline important knowledge gaps that need to be addressed in order to improve care of burn survivors.
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Affiliation(s)
- Efstathia Polychronopoulou
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas.,Shriners Hospitals for Children - Galveston, Galveston, Texas
| | - David N Herndon
- Shriners Hospitals for Children - Galveston, Galveston, Texas.,Department of Surgery, University of Texas Medical Branch, Galveston, Texas
| | - Craig Porter
- Shriners Hospitals for Children - Galveston, Galveston, Texas.,Department of Surgery, University of Texas Medical Branch, Galveston, Texas
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22
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Rivas E, Tran J, Gutierrez IL, Chapa M, Herndon DN, Suman OE. Rehabilitation Exercise Increases Physical Activity Levels in Severely Burned Children While Improving Aerobic Exercise Capacity and Strength. J Burn Care Res 2020; 39:881-886. [PMID: 29596597 DOI: 10.1093/jbcr/irx045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
This study tested the hypothesis that participation in a rehabilitation exercise program following hospital discharge would increase the level of physical activity in burned children than that seen in free-living nonburned children. Thirty-one severely burned children (12 ± 3 years, 144 ± 18 cm, 42 ± 17 kg, 48 ± 12% TBSA burns) were matched to 31 nonburned children (12 ± 3 y, 147 ± 17 cm, 45 ± 15 kg) based on age and sex. Pedometers were used to track minutes and steps in burned children during their exercise rehabilitation and nonburned children under free-living conditions (healthy control). We found that the average minutes of activity per day was lower in burned children (56 ± 25minutes) than in nonburned children (74 ± 28 minutes, P < .05). However, no difference was detected for average steps per day or week or maximal minutes in 1 day or week. At discharge, burn children had peak torque and mean power values that were 61% of nonburned values, and exercise training improved these by 27 and 28%, respectively (88 and 89% of nonburned values; each P ≤ .0001). Likewise, cardiorespiratory fitness at discharge was 72% of nonburned values, and exercise training improved fitness by 10% (82% of nonburned values, P < .05). Percentage TBSA burned was inversely associated with steps (r = -0.54, P = .001) and minutes of activity (r = -0.53, P = .002), accounting for 28-29% of the variability in burned children. These results show that, at discharge, burned children are capable of matching steps of physical activity levels seen in nonburned healthy children. Physical activity monitoring may be a viable option for continued improvement of physical exercise capacity when burned children are under free-living conditions.
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Affiliation(s)
- Eric Rivas
- Shriners Hospitals for Children, Galveston, TX.,Department of Surgery, University of Texas Medical Branch, Galveston.,Department of Kinesiology and Sport Management, Texas Tech University, Lubbock
| | - Joan Tran
- Shriners Hospitals for Children, Galveston, TX.,Department of Surgery, University of Texas Medical Branch, Galveston
| | | | - Martha Chapa
- Shriners Hospitals for Children, Galveston, TX.,Department of Surgery, University of Texas Medical Branch, Galveston
| | - David N Herndon
- Shriners Hospitals for Children, Galveston, TX.,Department of Surgery, University of Texas Medical Branch, Galveston
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23
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Rezaei M, Jalali R, Heydarikhayat N, Salari N. Effect of Telenursing and Face-to-Face Training Techniques on Quality of Life in Burn Patients: A Clinical Trial. Arch Phys Med Rehabil 2019; 101:667-673. [PMID: 31874153 DOI: 10.1016/j.apmr.2019.10.197] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 10/27/2019] [Accepted: 10/31/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To compare the effect of telenursing and face-to-face training on the quality of life (QOL) of patients with a burn injury. DESIGN This clinical trial with pretest-posttest design on 3 groups was conducted in Kermanshah, Iran, from 2017 to 2018. Convenience sampling was used. SETTING A tertiary hospital in Kermanshah, west of Iran. PARTICIPANTS A total of 90 patients with burns of grade 2 and 3 after discharge from the hospital were randomly assigned to 3 groups including telenursing (30), face-to-face training (30), and control (30). INTERVENTIONS Each intervention group received 1-on-1 telephone training and face-to-face training in 8 sessions (2 sessions of 15 to 20min/wk). The control group received regular care. MAIN OUTCOME MEASURES QOL was evaluated by the Burn Specific Health Scale-Brief (BSHS-B). RESULTS The mean BSHS-B scores before and after intervention for telenursing, face-to-face, and the control group were 71.43±21.92 and 133.06±11.97; 64.83±26.16 and 124.83±23.05; and 58.63±20.89 and 73.13±33.04, respectively. There was a statistically significant difference among the 3 groups with respect to the training methods after intervention (P<.001). In addition, post hoc test did not show a significant difference between the telenursing and face-to-face groups (P=.244). CONCLUSIONS Educational methods in the form of telenursing and face-to-face training were effective and promoted QOL in survivors of burn injuries. Both telenursing and face-to-face training can be used to improve the QOL of survivors of burn injuries during the rehabilitation phase.
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Affiliation(s)
- Mohsen Rezaei
- Nursing Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Department of Nursing, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | | | - Nader Salari
- Biostatistics Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
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24
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de Figueiredo TB, Utsunomiya KF, de Oliveira AMRR, Pires-Neto RC, Tanaka C. Mobilization practices for patients with burn injury in critical care. Burns 2019; 46:314-321. [PMID: 31466922 DOI: 10.1016/j.burns.2019.07.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/10/2019] [Accepted: 07/27/2019] [Indexed: 12/23/2022]
Abstract
PURPOSE Patients with burn usually undergo prolonged hospitalization due partially to the treatment of wounds and scars. Although the benefits of early mobilization are well-known in critical care patients, there are a lack of studies reporting mobilization practices and functional status for patients with burn. MATERIALS Clinical and physiotherapy data were daily collected, including ICU mobility scale (IMS) and reported barriers to mobilization therapy during a one-year period. At hospital discharge, the 6-min walking test (6MWT), Medical Research Council scale (MRCS) and handgrip strength test were applied to evaluate the patients' functionality. RESULTS Of the 74 patients admitted, 66% were placed on mechanical ventilation (MV). Mobilization therapy was administered in 67.2% of physiotherapy sessions, with passive mobilization being the most prevalent (53.2%) followed by active in-bed exercises (13.6%). Reported barriers for mobilization included hemodynamic instability followed by limited time for assistance. At hospital discharge, the 6MWD was 270(136) meters. A positive correlation was found between handgrip evaluation and 6MWD and a negative correlation with hospital length of stay. CONCLUSIONS Mobilization therapy of patients with burns in the ICU was characterized by a low mobility level during MV with a low functional status at hospital discharge.
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Affiliation(s)
- Thaís Borgheti de Figueiredo
- Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil.
| | - Key Fujisaki Utsunomiya
- Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil.
| | - Amanda Maria Ribas Rosa de Oliveira
- Burn ICU, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira César - CEP 05403-010, São Paulo, SP, Brazil.
| | - Ruy Camargo Pires-Neto
- Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil.
| | - Clarice Tanaka
- Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária - CEP 05360-000, São Paulo, SP, Brazil.
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Mohammadhossini S, Ahmadi F, Gheibizadeh M, Saki Malehi A, Zarea K. Comprehensive physical domain care needs of burn patients: a qualitative study. Clin Cosmet Investig Dermatol 2019; 12:573-581. [PMID: 31686885 PMCID: PMC6709513 DOI: 10.2147/ccid.s215517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/29/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Burn patients have various physical needs. To provide full care for such patients, we need a broad range of services. The current study aims at showing the physical needs of burn patients. METHODS The current qualitative study has been done through content analysis. The data were collected from 20 in-depth, unstructured individual interviews with hospitalized patients with burns on more than 25% of their body, nurses, physiotherapists, and psychologists. The participants were selected by purposive sampling. The data were analyzed with a conventional content analysis approach using the Elo and Kyngas method. RESULTS By analyzing the data, 7 main categories were obtained from 932 primary codes: the necessity to provide optimal physiotherapy, the necessity of the patient's overall physical assessment, the necessity of monitoring and coordination in care, healthy nutrition for burn patients, the need for pharmacotherapy, the need for pain reliefs, and finally the theme for comprehensive physical care needs in burn patients. CONCLUSION According to the findings, by applying the extracted categories, it is possible to provide quality care based on the patient's individual needs. This can help speed up the treatment and shorten the length of hospitalization significantly.
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Affiliation(s)
- Sima Mohammadhossini
- Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahin Gheibizadeh
- Nursing Care Research Center in Chronic Diseases, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki Malehi
- Biostatistics and Epidemiology Department, Public Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Ozkal O, Yurdalan SU, Seyyah M, Acar HA. The effect of burn severity on functional capacity in patients with burn injury. J Back Musculoskelet Rehabil 2019; 32:215-221. [PMID: 30248034 DOI: 10.3233/bmr-171106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Burns are traumatic injuries that result in severe tissue damage. A reduction in exercise capacity is the most common functional impairment, although it is not clear to what extent the severity of the burn injury affects the exercise capacity. OBJECTIVE The aim of this study was to examine the physiological responses to exercise and to evaluate exercise capacity according to burn severity. METHODS The study included a total of 64 burn patients, comprising 33 with moderate injuries (Total body surface area: 9.93 ± 4.73%; mean age: 37 ± 11.93 years) and 31 with major injuries (Total body surface area: 39.03 ± 10.36%; mean age: 41.09 ± 14.96 years). Heart rate, systolic blood pressure, diastolic blood pressure, double product, dyspnea level, oxygen saturation and leg fatigue before and after the shuttle walk test were recorded. Walking distances were measured after the shuttle walk test. RESULTS A significant difference was determined between patients with major and moderate burn injuries in respect of the cardiovascular responses to the shuttle walk test. Major burn injury patients had a significantly shorter walking distance than the moderate burn injury patients (p< 0.05). CONCLUSIONS Burn injury severity was seen to affect the functional capacity and cardiovascular responses to the shuttle walk test. Shuttle walk test can be preferred to evaluate moderate and major burn injury patients' functional capacity in the acute period of injury.
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Affiliation(s)
- Ozden Ozkal
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Saadet Ufuk Yurdalan
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Mine Seyyah
- Burn and Wound Treatment Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Hakan Ahmet Acar
- Burn and Wound Treatment Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
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Betancourt-Cárdenas PA, Camargo-Caldas NE, Rodríguez-Camacho DF, Lozano-Rivera E, Correa JF. Prescripción del ejercicio físico y sus implicaciones en adultos que han sufrido quemaduras. REVISTA DE LA FACULTAD DE MEDICINA 2019. [DOI: 10.15446/revfacmed.v67n1.66776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La prescripción del ejercicio físico y sus implicaciones en pacientes que han sufrido quemaduras es objeto de estudio en diferentes investigaciones debido al impacto físico, psicológico y social que tiene en las personas.Objetivo. Describir la prescripción de ejercicio físico y sus implicaciones en la población adulta que ha sufrido quemaduras.Materiales y métodos. Se realizó una revisión de tema por medio de exploración de artículos de manera electrónica con filtros de búsqueda en distintas bases de datos con términos DeCS y MeSH.Resultados. Se seleccionaron 11 artículos con intervención de ejercicio físico en fases aguda y crónica. Se incluyeron estrategias sobre la fuerza muscular en cinco de los artículos: tres de resistencia cardiovascular; dos de rango de movimiento, flexibilidad y características tróficas de la piel, y uno de dolor.Conclusiones. Las variables de la prescripción se determinan de acuerdo a las características propias que presenta la persona con quemadura, las cuales se resumen en esta revisión.
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Spronk I, Legemate C, Oen I, van Loey N, Polinder S, van Baar M. Health related quality of life in adults after burn injuries: A systematic review. PLoS One 2018; 13:e0197507. [PMID: 29795616 PMCID: PMC5967732 DOI: 10.1371/journal.pone.0197507] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 05/03/2018] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Measurement of health-related quality of life (HRQL) is essential to qualify the subjective burden of burns in survivors. We performed a systematic review of HRQL studies in adult burn patients to evaluate study design, instruments used, methodological quality, and recovery patterns. METHODS A systematic review was performed. Relevant databases were searched from the earliest record until October 2016. Studies examining HRQL in adults after burn injuries were included. Risk of bias was scored using the Quality in Prognostic Studies tool. RESULTS Twenty different HRQL instruments were used among the 94 included studies. The Burn Specific Health Scale-Brief (BSHS-B) (46%), the Short Form-36 (SF-36) (42%) and the EuroQol questionnaire (EQ-5D) (9%) were most often applied. Most domains, both mentally and physically orientated, were affected shortly after burns but improved over time. The lowest scores were reported for the domains 'work' and 'heat sensitivity' (BSHS-B), 'bodily pain', 'physical role limitations' (SF-36), and 'pain/discomfort' (EQ-5D) in the short-term and for 'work' and 'heat sensitivity', 'emotional functioning' (SF-36), 'physical functioning' and 'pain/discomfort' in the long-term. Risk of bias was generally low in outcome measurement and high in study attrition. CONCLUSION Consensus on preferred validated methodologies of HRQL measurement in burn patients would facilitate comparability across studies, resulting in improved insights in recovery patterns and better estimates of HRQL after burns. We recommend to develop a guideline on the measurement of HRQL in burns. Five domains representing a variety of topics had low scores in the long-term and require special attention in the aftermath of burns.
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Affiliation(s)
- Inge Spronk
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Public Health, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Catherine Legemate
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, VU University Medical Centre, Amsterdam, the Netherlands
| | - Irma Oen
- Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands
| | - Nancy van Loey
- Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, the Netherlands
- Utrecht University, Department of Clinical Psychology, Utrecht, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Margriet van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Public Health, Erasmus Medical Centre, Rotterdam, the Netherlands
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Yurdalan SU, Ünlü B, Seyyah M, Şenyıldız B, Çetin YK, Çimen M. Effects of structured home-based exercise program on depression status and quality of life in burn patients. Burns 2018. [PMID: 29534886 DOI: 10.1016/j.burns.2018.02.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Burns can cause life-threatening injuries and severe limitations. This study aimed to evaluate the effects of the structured home-based exercise program on depression status and quality of life in burn patients. MATERIALS AND METHODS This study was carried out in the Wound and Burn Treatment Department of University of Health Sciences, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul. Thirty burn patients voluntarily participated in this study. Patients' demographic data such as burn area and grade, percentage, type, number of grafts, and duration of hospitalization were recorded. The quality of life was evaluated using the Short Form-36 (SF-36), and depression status was evaluated using Beck Depression Inventory (BDI). The home-based exercise program was defined by the clinical physiotherapist on the day when the patient was discharged. The home-based exercise program was applied for 3 weeks. Evaluations were performed at discharge and repeated after 3 weeks at the end of the exercise program. RESULTS Of the 30 patients who completed the study (age range, 21-61 years; mean, 34.9±12.99 years), 96.7% (n=29) were male and 3.3% (n=1) were female. A statistically significant difference was observed between BDI and SF-36 scores before and after the home-based exercise program (p<0.05). BDI scores decreased after the home-based exercise program, whereas SF-36 scores increased. CONCLUSION Our study concludes that burn patients who underwent the structured home-based exercise programs attained acceleration of their physical, social, and psychological integrity. Thus, establishing a structured home-based exercise program according to the burn type and clinical course should be continued.
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Affiliation(s)
- Saadet Ufuk Yurdalan
- Marmara University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Başıbüyük Mahallesi, Maltepe Başıbüyük Yolu Sokak, 9/4/1 Maltepe, Istanbul, Turkey.
| | - Begüm Ünlü
- Marmara University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Başıbüyük Mahallesi, Maltepe Başıbüyük Yolu Sokak, 9/4/1 Maltepe, Istanbul, Turkey.
| | - Mine Seyyah
- University of Health Sciences Kartal Dr. Lütfi Kırdar Education and Research Hospital, Wound and Burn Treatment Department, Cevizli Mahallesi, Şemsi Denizer Caddesi, E-5 Karayolu Cevizli Mevkii, 34890 Kartal, Istanbul, Turkey.
| | - Batuhan Şenyıldız
- Marmara University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Başıbüyük Mahallesi, Maltepe Başıbüyük Yolu Sokak, 9/4/1 Maltepe, Istanbul, Turkey.
| | - Yunus Kubilay Çetin
- Marmara University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Başıbüyük Mahallesi, Maltepe Başıbüyük Yolu Sokak, 9/4/1 Maltepe, Istanbul, Turkey.
| | - Menekşe Çimen
- Marmara University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Başıbüyük Mahallesi, Maltepe Başıbüyük Yolu Sokak, 9/4/1 Maltepe, Istanbul, Turkey.
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Elsherbiny OE, El Fahar MH, Weheida SM, Shebl AM, Shrief WI. Effect of burn rehabilitation program on improving quality of life (QoL) for hand burns patients: a randomized controlled study. EUROPEAN JOURNAL OF PLASTIC SURGERY 2017. [DOI: 10.1007/s00238-017-1379-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gittings PM, Grisbrook TL, Edgar DW, Wood FM, Wand BM, O'Connell NE. Resistance training for rehabilitation after burn injury: A systematic literature review & meta-analysis. Burns 2017; 44:731-751. [PMID: 29017743 DOI: 10.1016/j.burns.2017.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/14/2017] [Accepted: 08/11/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND/AIM Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury. METHODS Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and rated using the GRADE framework. RESULTS Eleven studies matched our inclusion criteria. Primary analysis did not demonstrate significant improvements for increasing muscle strength (SMD 0.74, 95% CI -0.02 to 1.50, p=0.06). Sensitivity analysis to correct an apparent anomaly in published data suggested a positive effect (SMD 0.37, 95% CI 0.08-0.65, p=0.01). Psychological quality of life demonstrated benefit from training (MD=25.3, 95% CI 3.94-49.7). All studies were rated as having high risk of bias. The quality of the evidence was rated as low or very low. CONCLUSION Further research with robust methodology is recommended to assess the potential benefit suggested in this review.
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Affiliation(s)
- Paul M Gittings
- State Adult Burn Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Perth, Western Australia, Australia; School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
| | - Tiffany L Grisbrook
- Fiona Wood Foundation, Perth, Western Australia, Australia; School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia
| | - Dale W Edgar
- State Adult Burn Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Perth, Western Australia, Australia; Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Fiona M Wood
- State Adult Burn Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Perth, Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | - Benedict M Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Neil E O'Connell
- Health Economics Research Group, Institute of Environment, Health and Societies, Department of Clinical Sciences, Brunel University London, Uxbridge, United Kingdom
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Foster N, Kornhaber R, McGarry S, Wood FM, Edgar DW. Heterotopic Ossification in adults following a burn: A phenomenological analysis. Burns 2017; 43:1250-1262. [PMID: 28413106 DOI: 10.1016/j.burns.2017.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/05/2017] [Accepted: 03/08/2017] [Indexed: 11/30/2022]
Abstract
Heterotopic Ossification (HO) is a rare but severely debilitating complication after a burn. Despite there being literature of varying quality explaining the postulated pathological process, risk factors and treatment for HO, the individual experiences of adults diagnosed with HO following a burn, remains unreported. This study sought to explore and describe burn survivors' experiences of HO to gain a greater understanding of the clinical needs for this unique patient population. A phenomenological inquiry of five men and one woman selected through purposeful sampling collected in-depth interviews analysed using Colaizzi's method of data analysis. Five emergent themes: (1) Early signs and symptoms, (2) Impact on the rehabilitation journey, (3) The role of the health care professionals (4) Loss of independence and an increased reliance on others and, (5) Learning to live with it: uncertainty, hope and adaptation. Eleven cluster themes were identified, highlighting the meaning of each emergent theme. These findings describe the significant impact the unique symptomology of HO had on the physical and psychosocial functioning of participants throughout the rehabilitation journey. Central to engagement in rehabilitation, is the participants' desire for autonomy particularly in the domains of living independently and community re-integration.
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Affiliation(s)
- Nichola Foster
- Sir Charles Gairdner Hospital, Physiotherapy Department, Perth, Australia; The University of Norte Dame, School of Physiotherapy, Fremantle, Australia
| | - Rachel Kornhaber
- University of Tasmania, Faculty of Health, School of Health Sciences, Sydney Campus, Australia; National Burns Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Sarah McGarry
- Total Care burn Unit, Princess Margaret Hospital, Perth, Western Australia, Australia; School of Exercise and Health Sciences, Edith Cowan University, Perth, Australia; Burns Service Western Australia, Perth, Australia; Fiona Wood Foundation, Murdoch, Australia
| | - Fiona M Wood
- Total Care burn Unit, Princess Margaret Hospital, Perth, Western Australia, Australia; Burns Service Western Australia, Perth, Australia; Burn Injury Research Unit, School of Surgery, University of Western Australia, Australia; State Adult Burn Unit, Fiona Stanley Hospital, Perth, Murdoch, Australia; Fiona Wood Foundation, Murdoch, Australia
| | - Dale W Edgar
- Burns Service Western Australia, Perth, Australia; Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Australia; State Adult Burn Unit, Fiona Stanley Hospital, Perth, Murdoch, Australia; Fiona Wood Foundation, Murdoch, Australia.
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A Systematic Review of Patient-Reported Outcome Measures Used in Adult Burn Research. J Burn Care Res 2017; 38:e521-e545. [DOI: 10.1097/bcr.0000000000000474] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Lower-Limb Muscular Strength, Balance, and Mobility Levels in Adults Following Severe Thermal Burn Injuries. J Burn Care Res 2017; 38:327-333. [DOI: 10.1097/bcr.0000000000000495] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gonçalves N, Ciol MA, Dantas RAS, Farina Junior JA, Rossi LA. A randomized controlled trial of an educational programme with telephone reinforcement to improve perceived health status of Brazilian burn victims at 6-month post discharge. J Adv Nurs 2016; 72:2508-23. [PMID: 27189899 DOI: 10.1111/jan.13003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to compare health status, self-efficacy, symptoms of depression and anxiety and post-traumatic stress between two groups of burn victims receiving information on self-care through routine care or an educational programme with telephone reinforcement. BACKGROUND Self-care post discharge is an important factor on quality of life of burn victims. Reinforcement of self-care programme via telephone follow-up might improve self-efficacy and general health perception in burn victims. DESIGN Randomized, controlled clinical trial. METHOD From 2011-2012, we randomized 108 burn victims either to an educational programme on self-care tailored for burn victims according to the cognitive social theory and reinforcement by telephone every 4-6 weeks for 6 months post discharge, or to the routine instructions given at discharge from the hospital. During hospitalization, at discharge, at 6 and 12 months post discharge, we collected data on socio-demographic characteristics, Burns Specific Health Scale Revised (BSHS-R), Perceived Self-Efficacy Scale (PSE), Hospital Anxiety and Depression Scales (HADS) and Impact of the Event Scale (IES). We analysed data using t-test, Chi-square test and linear regression models. RESULTS Groups were similar regarding clinical and demographic characteristics, except for age. At 6-month follow-up, there were no differences between the groups on BSHS-R, PSE and HADS Depression, while the intervention group showed fewer symptoms of anxiety (HADS Anxiety) and lower IES scores than the control group. CONCLUSION The educational programme, when compared with usual care, reduced anxiety symptoms and post-traumatic stress. Educational programmes with telephone follow-up might be a viable intervention to improve self-care for burn victims.
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Affiliation(s)
| | - Marcia Aparecida Ciol
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Jayme Adriano Farina Junior
- Division of Plastic Surgery and the Burn Unit at Hospital das Clínicas, Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Practice Guidelines for Cardiovascular Fitness and Strengthening Exercise Prescription After Burn Injury. J Burn Care Res 2016; 37:e539-e558. [DOI: 10.1097/bcr.0000000000000282] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tang D, Li-Tsang CW, Au RK, Li KC, Yi XF, Liao LR, Cao HY, Feng YN, Liu CS. Functional Outcomes of Burn Patients with or without Rehabilitation in Mainland China. Hong Kong J Occup Ther 2015. [DOI: 10.1016/j.hkjot.2015.08.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background/Objective To evaluate the functional outcomes of moderate to severe burn patients with and without rehabilitation in terms of self-care performance and quality of life (QOL). Methods Fifty-five patients with total burn surface area of 30% or more were divided into two groups: rehabilitation and conventional care groups. The rehabilitation group underwent comprehensive rehabilitation interventions (e.g., occupational therapy, physiotherapy, and patient and family education) in addition to standard clinical interventions received by the conventional care group. The outcomes included self-care performance (Modified Barthel Index [MBI]), QOL (World Health Organization Quality of Life-BREF), pain and itchiness (Visual Analogue Scale [VAS]), quality of sleep, and mental health (Self-Rating Depression Scale [SDS] and Self-Rating Anxiety Scale) measured before and 3 months after the intervention. Results After the intervention, significant improvements were found in MBI, all dimensions of QOL, pain, and SDS in the rehabilitation group (all p < .05). In the conventional care group, significant improvements were found only in MBI (p < .001), the physical health dimension of QOL (p < .01), and pain (p < .001). Group comparisons showed that the rehabilitation group achieved significantly better outcomes after the intervention in MBI (p < .001), VAS score of itching (p = .009), and the physical health (p = .002), psychological health (p = .021), and social relationships dimensions of QOL (p < .001). Conclusion Patients with moderate to severe burn injuries can benefit from rehabilitation interventions in terms of physical health, mental health, performance of daily living, and QOL.
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Affiliation(s)
- Dan Tang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
- Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Cecilia W.P. Li-Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Ricky K.C. Au
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Kui-cheng Li
- Department of Occupational Therapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Xian-feng Yi
- Department of Burn Surgery and Burn Rehabilitation, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Lin-rong Liao
- Department of Physiotherapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Hai-yan Cao
- Department of Occupational Therapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Ya-nan Feng
- Department of Occupational Therapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Chuan-shun Liu
- Department of Occupational Therapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
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Randall SM, Fear MW, Wood FM, Rea S, Boyd JH, Duke JM. Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study. BMJ Open 2015; 5:e009395. [PMID: 26362668 PMCID: PMC4567662 DOI: 10.1136/bmjopen-2015-009395] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate if adults who are hospitalised for a burn injury have increased long-term hospital use for musculoskeletal diseases. DESIGN A population-based retrospective cohort study using linked administrative health data from the Western Australian Data Linkage System. SUBJECTS Records of 17,753 persons aged at least 20 years when hospitalised for a first burn injury in Western Australia during the period 1980-2012, and 70,758 persons who were age and gender-frequency matched with no injury admissions randomly selected from Western Australia's electoral roll. MAIN OUTCOME MEASURES Admission rates and cumulative length of stay for musculoskeletal diseases. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and HRs with 95% CIs, respectively. RESULTS After adjustment for pre-existing health status and demographic characteristics, the burn cohort had almost twice the hospitalisation rate for a musculoskeletal condition (IRR, 95% CI 1.98, 1.86 to 2.10), and spent 3.70 times as long in hospital with a musculoskeletal diagnosis (95% CI 3.10 to 4.42) over the 33-year period, than the uninjured comparison cohort. Adjusted survival analyses of incident post-burn musculoskeletal disease admissions found significant increases for the 15-year post burn discharge period (0-6 months: HR, 95% CI 2.51, 2.04 to 3.11; 6 months-2 years: HR, 95% CI 1.77, 1.53 to 2.05; 2-15 years: HR, 95% CI 1.32, 1.23 to 1.42). Incident admission rates were significantly elevated for 20 years post-burn for minor and severe burn injury for a range of musculoskeletal diseases that included arthropathies, dorsopathies, osteopathies and soft tissue disorders. CONCLUSIONS Minor and severe burn injuries were associated with significantly increased post-burn incident admission rates, long-term hospital use and prolonged length of stay for a range of musculoskeletal diseases. Further research is required that facilitates identification of at-risk patients and appropriate treatment pathways, to reduce the long-term morbidity associated with burns.
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Affiliation(s)
- Sean M Randall
- Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia
| | - Mark W Fear
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Fiona M Wood
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
- Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Western Australia, Australia
| | - Suzanne Rea
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
- Burns Service of Western Australia, Royal Perth Hospital and Princess Margaret Hospital, Perth, Western Australia, Australia
| | - James H Boyd
- Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia
| | - Janine M Duke
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
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Wasiak J, Paul E, Lee SJ, Mahar P, Pfitzer B, Spinks A, Cleland H, Gabbe B. Patterns of recovery over 12 months following a burn injury in Australia. Injury 2014; 45:1459-64. [PMID: 24698152 DOI: 10.1016/j.injury.2014.02.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 01/30/2014] [Accepted: 02/08/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe patients' generic health status and health-related quality of life (HRQoL) 12-months following admission to a state-wide burns service. METHODS A total of 114 injured adults with >10% total body surface area burned (TBSA) or burns less than 10% TBSA to smaller anatomical areas such as the hands and feet participated in this study. Retrospective assessment of pre-burn injury status and prospective assessment of generic health and HRQoL were followed up at 3, 6 and 12-months after injury using the 36-item Short Form Health Survey (SF-36 v.2) and Burns Specific Health Scale-Brief (BSHS-B). The SF-36 v.2 was administered retrospectively during the initial hospital stay to assess pre-injury HRQoL. Changes in instruments scores were assessed using multilevel mixed effects regression models. Mean scores were compared over time and between severity groups as defined by <10%, 10-30% and >30% TBSA. RESULTS For the overall sample, the SF-36 v.2 physical component scale (PCS) score between 3 and 12-months post-burn injury were significantly lower than pre-injury scores (p<0.01), with no significant change over time for the mental component scale (MCS) (p=0.36). Significant %TBSA-burden by time interactions highlighted changes from pre-burn injury in overall PCS (p=0.02), physical functioning (p<0.001) and role-physical (p=0.03), with subscales worse for the TBSA >30% group. With respect to the BSHS-B, significant improvement from 3 to 12-months post-burn injury was seen for the entire sample in simple abilities (p<0.001), hand function (p=0.001), work (p=0.01), and treatment regime (p=0.004) subscales. The TBSA >30% group showed a greater rate of improvement in simple abilities (p=0.01) and hand function (p=0.005) between 3 and 12 months post-burn injury. CONCLUSIONS Whilst certain HRQoL measures improve over the 12-months, in most cases they do not reach pre-morbid levels. Patients face ongoing challenges regarding their physical and psychosocial recovery 12-months post-burn injury with respect to generic health and burn-specific health. These challenges vary at different time periods over the 12-month post-burn period, and may provide windows of opportunity in which to address ongoing issues.
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Affiliation(s)
- J Wasiak
- Victorian Adult Burns Service and School of Public Health and Preventive Medicine, Monash University, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia.
| | - E Paul
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Commercial Road, Melbourne, Australia
| | - S J Lee
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Commercial Road, Melbourne, Australia
| | - P Mahar
- Victorian Adult Burns Service, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia
| | - B Pfitzer
- Victorian Adult Burns Service, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia
| | - A Spinks
- CSIRO Ecosystem Sciences, Queensland, Australia
| | - H Cleland
- Victorian Adult Burns Service, Department of Surgery, Monash University, The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia
| | - B Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Commercial Road, Melbourne, Australia
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Abstract
Exercise programs capable of contributing positively to the long-term rehabilitation of burn patients should be included in outpatient rehabilitation programs. However, the extent and intensity of the resistance and cardiopulmonary exercise prescribed are unclear. This study was conducted to investigate the existence, design, content, and prescription of outpatient cardiopulmonary and resistance exercise programs within outpatient burn rehabilitation. A survey was designed to gather information on existing exercise programs for burn survivors and to assess the extent to which these programs are included in overall outpatient rehabilitation programs. Three hundred and twenty-seven surveys were distributed in the licensed physical and occupational therapists part of the American Burn Association Physical Therapy/Occupational Therapy Special Interest Group. One hundred and three surveys were completed. Eighty-two percent of respondents indicated that their institutions offered outpatient therapy after discharge. The frequency of therapists' contact with patients during this period varied greatly. Interestingly, 81% of therapists stated that no hospital-based cardiopulmonary endurance exercise programs were available. Patients' physical function was infrequently determined through the use of cardiopulmonary parameters (oxygen consumption and heart rate) or muscle strength. Instead, more subjective parameters such as range of motion (75%), manual muscle testing (61%), and quality of life (61%) were used. Prescription and follow-up assessment of cardiopulmonary endurance training are inconsistent among institutions, underscoring the need for greater awareness of the importance of exercise in any burn rehabilitation program. Identification of cardiopulmonary and progressive resistance parameters for establishing and tracking exercise training is also needed to maximize exercise-induced benefits.
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Mohaddes Ardebili F, Manzari ZS, Bozorgnejad M. Effect of educational program based on exercise therapy on burned hand function. World J Plast Surg 2014; 3:39-46. [PMID: 25489523 PMCID: PMC4236988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 10/05/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Hands burn was associated with significant functional disorders that severely affected patient's quality of life. The aim of this study was to examine the effect of educational program based on exercise therapy on burned hand function. METHODS This experimental research was conducted in a period of ten months in 2010-2011 in Mottahari Hospital in Tehran in Iran. The sample included 60 patients, who were randomly assigned into experimental and control groups, half in intervention and half in control group. Educational program was implemented on experimental group. The data collection tools were two observational checklists about determining of hand function. RESULTS Both groups were matched in characteristic of demographic and burn injury. Subjects in experimental group demonstrated significant improvements in range of motion and hand function balance from admission to discharge. CONCLUSION In order to reduce the hand functional impairment caused by burns, it is recommended that special attention be paid to patient education about exercise therapy.
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Affiliation(s)
- Fatemeh Mohaddes Ardebili
- Medico-Surgical Group, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Sadat Manzari
- Medico-Surgical Group, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehri Bozorgnejad
- Medico-Surgical Group, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Zhang LJ, Cao J, Feng P, Huang J, Lu J, Lu XY, Xia ZF. Influencing factors of the quality of life in Chinese burn patients: Investigation with adapted Chinese version of the BSHS-B. Burns 2013; 40:731-6. [PMID: 24280529 DOI: 10.1016/j.burns.2013.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 09/01/2013] [Accepted: 09/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The study aims to evaluate the quality of life (QOL) in burn patients in China and find out principal influencing factors, so as to provide evidence for interventions. METHODS A total of 271 burn patients in three major burn units in China were asked to fill in the adapted Chinese version (ACV) of the Burn Specific Health Scale-Brief (ACV BSHS-B) in order to seek out the principal influencing factors in combination with a self-designed demographic and disease condition questionnaire. Multivariable linear regression was used to analyse the principal influencing factors. RESULTS The findings showed that there were seven principal influencing factors for the overall ACV BSHS-B score. They were: percent total body surface area (TBSA) burned (with the standardised regression coefficient being -0.594), burn area of lower limber (0.241), itch level (-0.227), pain level (-0.220), gender (0.217), mechanical ventilation (0.216) and hand deformity (-0.141). CONCLUSION QOL decreased in burn patients to different degrees depending on the intensity of burns. With a better understanding of influencing factors of burn patients' QOL, the medical and nursing staff can take specific countermeasures to help patients gain a higher QOL.
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Affiliation(s)
- Ling-Juan Zhang
- Nursing Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Jie Cao
- Anesthesiology Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Ping Feng
- Burn Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Juan Huang
- Nursing Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Jian Lu
- Department of Medical Statistics, Second Military Medical University, Shanghai 200433, China
| | - Xiao-Ying Lu
- Nursing Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Zhao-Fan Xia
- Burn Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
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Grisbrook T, Elliott C, Edgar D, Wallman K, Wood F, Reid S. Burn-injured adults with long term functional impairments demonstrate the same response to resistance training as uninjured controls. Burns 2013; 39:680-6. [DOI: 10.1016/j.burns.2012.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 07/25/2012] [Accepted: 09/06/2012] [Indexed: 10/27/2022]
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Effects of a hospital based Wellness and Exercise program on quality of life of children with severe burns. Burns 2012; 39:599-609. [PMID: 22985974 DOI: 10.1016/j.burns.2012.08.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 08/13/2012] [Accepted: 08/21/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the effect of a 12-week Wellness and Exercise (W&E) program on the quality of life of pediatric burn survivors with burns of ≥40% total body surface area. We hypothesized this comprehensive regimen would improve physical and psychosocial outcomes. METHODS Children were recruited for participation upon their discharge from the ICU. They were not taking anabolic/cardiovascular agents. Seventeen children participated in the W&E group and 14 children in the Standard of Care (SOC) group. Quality of life was assessed with the Child Health Questionnaire (CHQ) at discharge and 3 months. Children completed the CHQ-CF 87 and caregivers completed the CHQ-PF 28. RESULTS The mean age of children in the W&E group was 14.07±3.5 years and mean TBSA was 58±11.8%. The mean age of children in the SOC group was 13.9±3.1 years and mean TBSA was 49±7.8%. ANOVA did not reveal statistically significant differences between the groups. Matched paired t-tests revealed that parents with children in the W&E group reported significant improvements with their children's physical functioning, role/social physical functioning, mental health, overall physical and psychosocial functioning after exercise. CONCLUSIONS These results are clinically relevant in that a comprehensive W&E program may be beneficial in promoting physical and psychosocial outcomes.
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