The current Standard of Care for the rehabilitation of severely burned children is to discharge the patientfrom the hospital, with a written set of instructions for physical and occupational therapy activities at home, in an unsupervised environment. These activities do not significantly impact the persistent and extensive skeletal muscle catabolism and weakness characteristic of severe burns. The central hypothesis of this grant is that a supervised and structured aerobic and resistance exercise program implemented at hospital discharge in severely burned children will improve physical structure and function, allowing for an improvement in quality of life (QOL). We propose the following specific aims (SA): SA1 will test the hypothesis that in severely burned children, a supervised and structured exercise program will significantly increase muscle mass and bone mass more than the current Standard of Care. SA2 will test the hypothesis that in burned children, a supervised and structured exercise program will significantly increase peak aerobic capacity and muscle strength more than the current Standard of Care. SA3 will test the hypothesis that a supervised and structured exercise program will significantly increase net protein synthesis compared to the current Standard of Care in burned children and lead to an improvement in lean mass and muscle strength. A4 will test the hypothesis that in burned children, a supervised and structured exercise program will significantly improve QOL more than the current Standard of Care. Primary outcomes are peak aerobic capacity assessed with a cardiopulmonary exercise test;muscle strength, using leg dynamometry, muscle ass assessed using dual X-ray absorptiometry, and net protein balance assessed using urea enrichment. Finally, psychosocial health using the Child Health Questionnaire, (PF-28 and CF-87) will be assessed. Assessment of physical function, and QOL will be done at hospital discharge, at the end of the 12-week exercise program, at 12 months, and at 24 months post burn. Assessment of net protein balance will be done at hospital discharge, and at the end of the 12-week exercise program. It is expected that these proposed studies will expand the present knowledge of physical and psychosocial rehabilitation programs for severely burned children. Furthermore, we believe that these proposed studies will result in novel and clinically relevant data that may in turn establish new guidelines for the Standard of Care of burned children.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD049471-09
Application #
8606222
Study Section
Skeletal Muscle and Exercise Physiology Study Section (SMEP)
Program Officer
Maholmes, Valerie
Project Start
2006-08-01
Project End
2015-01-31
Budget Start
2014-02-01
Budget End
2015-01-31
Support Year
9
Fiscal Year
2014
Total Cost
$249,331
Indirect Cost
$84,986
Name
University of Texas Medical Br Galveston
Department
Surgery
Type
Schools of Medicine
DUNS #
800771149
City
Galveston
State
TX
Country
United States
Zip Code
77555
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Ojeda, Sylvia; Blumenthal, Emily; Stevens, Pamela et al. (2018) The Safety and Efficacy of Propranolol in Reducing the Hypermetabolic Response in the Pediatric Burn Population. J Burn Care Res 39:963-969
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Cambiaso-Daniel, Janos; Parry, Ingrid; Rivas, Eric et al. (2018) Strength and Cardiorespiratory Exercise Rehabilitation for Severely Burned Patients During Intensive Care Units: A Survey of Practice. J Burn Care Res 39:897-901
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Rivas, Eric; McEntire, Serina J; Herndon, David N et al. (2018) Resting ?-Adrenergic Blockade Does Not Alter Exercise Thermoregulation in Children With Burn Injury: A Randomized Control Trial. J Burn Care Res 39:402-412
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Rivas, Eric; Herndon, David N; Cambiaso-Daniel, Janos et al. (2018) Quantification of an Exercise Rehabilitation Program for Severely Burned Children: The Standard of Care at Shriners Hospitals for Children®-Galveston. J Burn Care Res 39:889-896

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