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Godleski M, Yelvington M, Jean S. Burn Injury Complications Impacting Rehabilitation. Phys Med Rehabil Clin N Am 2023; 34:799-809. [PMID: 37806698 DOI: 10.1016/j.pmr.2023.06.020] [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] [Indexed: 10/10/2023]
Abstract
Successful post-burn rehabilitation requires an understanding of a wide range of complications to maximize functional recovery. This article reviews a range of potential challenges including burn scar contracture, amputation, peripheral nerve injury, heterotopic ossification, dysphagia, altered skin physiology, pain, and pruritis. The overall focus is to serve as a guide for post-injury therapy and rehabilitation spanning the phases of care and considering evidence-based approaches, prevention, and treatment with an ultimate goal of aiding in the functional recovery and long-term quality of life for burn survivors.
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Affiliation(s)
- Matthew Godleski
- Department of Physical Medicine and Rehabilitation, Sunnybrook Health Sciences Centre, University of Toronto, St. John's Rehab, 285 Cummer Avenue, Toronto, Ontario M2M 2G1, Canada.
| | - Miranda Yelvington
- Department of Rehabilitation, Arkansas Children's Hospital, 1 Children's Way, Slot 104, Little Rock, AR 72202, USA
| | - Stephanie Jean
- Department of Physical Medicine and Rehabilitation, Institut de Réadaptation Gingras-Lindsay de Montréal (Darlington), Université de Montréal, 6300 Avenue Darlington, Montréal, Québec H3S 2J4, Canada
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Chen J, Caluori C, Alberton L, Zhang J, Shashoua D, Calva V, Gauthier N, Edger-Lacoursière Z, de Oliveira A, Marois-Pagé E, Nedelec B. Validation of the Burn Survivor Fear-Avoidance Questionnaire and Its Association With Pain Intensity, Catastrophizing, and Disability. J Burn Care Res 2023; 44:1189-1199. [PMID: 36812056 DOI: 10.1093/jbcr/irad025] [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: 11/25/2022] [Indexed: 02/24/2023]
Abstract
According to the Fear-avoidance (FA) model, FA beliefs can lead to disability due to avoidance of activities expected to result in pain or further injury. Extensive research on the relationship of FA, pain, catastrophizing, and disability has been generated with patients suffering from chronic neck and back pain, but little research has been conducted with burn survivors. To address this need, the Burn Survivor FA Questionnaire (BSFAQ) was developed (Langlois J, Vincent-Toskin, S, Duchesne, P et al. Fear-avoidance beliefs and behaviors of burn survivors: A mixed-methods approach. Burns 2021;47:175-89.) but has not been validated. Thus, the primary objective of this study was to investigate the construct validity of the BSFAQ among burn survivors. The secondary objective was to examine the relationship between FA and 1) pain intensity and 2) catastrophizing at baseline, 3 months and 6 months postburn, and 3) disability among burn survivors at 6 months postburn. A prospective mixed-methods approach was used to examine the construct validity by comparing the quantitative scores of the BSFAQ to independently performed qualitative interviews of burn survivors (n = 31) that explored their lived experiences, to determine if the BSFAQ discriminated those who had, from those who did not have FA beliefs. Data for the secondary objective, scores of burn survivors (n = 51) pain intensity (numeric rating scale), catastrophizing (pain catastrophizing scale), and disability (Burn Specific Health Scale-brief), were collected through a retrospective chart review. For the primary objective, Wilcoxon rank sum test results showed a statistically significant difference (P = .015) between the BSFAQ scores of participants who were identified from the qualitative interviews as fear avoidant compared to those who were identified as non fear avoidant, with a receiver operating characteristic curve indicating that the BSFAQ correctly predicted FA 82.4% of the time. For the secondary objective, Spearman correlation test results showed a moderate correlation between FA and 1) pain at baseline (r = .466, P = .002), 2) catastrophizing thoughts over time (r = .557, P = .000; r = .470, P = .00; r = .559, P = .002 respectively at each time point), and 3) disability at 6 months postburn (r = -.643, P = .000). These results support that the BSFAQ is able to discriminate which burn survivors are experiencing FA beliefs. It is also consistent with the FA model since burn survivors who express FA are more likely to report higher levels of pain early during their recovery that correlates with persistently elevated catastrophizing thoughts and ultimately results in higher self-reported disability. The BSFAQ demonstrates construct validity and is able to correctly predict fear-avoidant burn survivors; however, additional research is required to further examine the BSFAQ's clinimetric properties.
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Affiliation(s)
- Jocelyn Chen
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Cassandra Caluori
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Laura Alberton
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Jinny Zhang
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | | | - Valérie Calva
- Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
| | | | - Zoë Edger-Lacoursière
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Ana de Oliveira
- Centre de recherche, Center hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | | | - Bernadette Nedelec
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
- Centre de recherche, Center hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
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Shupp JW, Holmes JH, Moffatt LT, Phelan HA, Sousse L, Romanowski KS, Jeschke M, Kowalske KJ, Badger K, Allely R, Cartotto R, Burmeister DM, Kubasiak JC, Wolf SE, Wallace KF, Gillenwater J, Schneider DM, Hultman CS, Wiechman SA, Bailey JK, Powell HM, Travis TE, Supp DM, Carney BC, Johnson LS, Johnson LS, Chung KK, Chung KK, Kahn SA, Gibson ALF, Christy RJ, Carter JE, Carson JS, Palmieri TL, Kopari NM, Blome-Eberwein SA, Hickerson WL, Parry I, Cancio JM, Suman O, Schulman CI, Lamendella R, Hill DM, Wibbenmeyer LA, Nygaard RM, Wagner AL, Carter ADW, Greenhalgh DG, Lawless MB, Carlson DL, Harrington DT. Proceedings of the 2021 American Burn Association State and Future of Burn Science Meeting. J Burn Care Res 2022; 43:1241-1259. [PMID: 35988021 DOI: 10.1093/jbcr/irac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Periodically, the American Burn Association (ABA) has convened a State of the Science meeting on various topics representing multiple disciplines within burn care and research. In 2021 at the request of the ABA President, meeting development was guided by the ABA's Burn Science Advisory Panel (BSAP) and a subgroup of meeting chairs. The goal of the meeting was to produce both an evaluation of the current literature and ongoing studies, and to produce a research agenda and/or define subject matter-relevant next steps to advance the field(s). Members of the BSAP defined the topics to be addressed and subsequently solicited for nominations of expert speakers and topic leaders from the ABA's Research Committee. Current background literature for each topic was compiled by the meeting chairs and the library then enhanced by the invited topic and breakout discussion leaders. The meeting was held in New Orleans, LA on November 2nd and 3rd and was formatted to allow for 12 different topics, each with two subtopics, to be addressed. Topic leaders provided a brief overview of each topic to approximately 100 attendees, followed by expert-lead breakout sessions for each topic that allowed for focused discussion among subject matter experts and interested participants. The breakout and topic group leaders worked with the participants to determine research needs and associated next steps including white papers, reviews and in some cases collaborative grant proposals. Here, summaries from each topic area will be presented to highlight the main foci of discussion and associated conclusions.
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