Clinical Outcomes in Rehabilitated Burn Children

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This proposal will test the hypothesis that an exercise program and the daily administration of recombinant human growth hormone will promote recovery to full physiological function in children after severe burn injury. An intervention study will be performed in which clinically relevant outcome parameters will be quantified at 3-month intervals up to one year post-burn. Half of the patients will be randomized to receive 0.05 mg/kg/d of recombinant human growth hormone or placebo injection throughout the year. Each group will be further randomized to participate in a 3-month exercise-conditioning program offered at the Shriners Burns Hospital, or receive standard home rehabilitation. Thus, 4 groups of patients will be studied up to one year post-burn. Endpoints of this study will be knee heights and standing height, body weight, lean body mass determined by 40K-counter and dual energy x-ray absorptiometry (DEXA), muscle strength, bone density, bone histomorphometry, and scar formation by the Vancouver Scar Scale. Identification and quantitation of types III, IV, and VII collagen will also be made from skin biopsies.