Exercise and Quality of Life in Severely Burned Children

R 目前严重烧伤儿童康复的护理标准是让患者出院 从医院，与一套书面指示，物理和职业治疗活动在家里， 无人监管的环境这些活动不会对持久和广泛的 严重烧伤后骨骼肌痉挛和虚弱。这项资助的核心假设是 在医院实施的有监督和结构化的有氧和阻力运动计划 严重烧伤儿童的出院将改善身体结构和功能， 改善生活质量（QOL）。我们提出以下具体目标（SA）：SA 1将测试 假设在严重烧伤的儿童中，一个有监督的和有组织的锻炼计划将显著地 增加肌肉质量和骨量超过目前的护理标准。SA 2将检验假设 在烧伤儿童中，有监督和有组织的运动计划将显著提高有氧峰值 能力和肌肉强度超过目前的护理标准。SA 3将测试假设， 监督和结构化的锻炼计划将显着增加净蛋白质合成相比， 目前烧伤儿童的护理标准，并导致瘦体重和肌肉力量的改善。 SA 4将检验这一假设，即在烧伤儿童中，一个有监督的、结构化的锻炼计划将 显著改善QOL超过目前的标准治疗。主要结果是有氧峰值 用心肺运动试验评估的能力;肌肉力量，用腿部测力计，肌肉 用X线吸收测定法评估质量，用尿素富集法评估净蛋白平衡。 最后，将使用儿童健康问卷（PF-28和CF-87）评估心理社会健康。 在12周结束时出院时进行身体功能和QOL评估 运动计划，在烧伤后12个月和24个月。净蛋白质平衡的评估将 在出院时完成，在12周锻炼计划结束时完成。预计这些 拟议的研究将扩大目前的身体和心理康复计划的知识， 严重烧伤的儿童此外，我们相信，这些拟议的研究将导致新的和 这些临床相关数据可能反过来为烧伤儿童的护理标准建立新的指南。

r The current Standard of Care for the rehabilitation of severely burned children is to discharge the patient from 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 anld 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, <p supervised and structured exercise program will significantly increase peak aerobic capacity and muscle strejngth more than the current Standard of Care. SA3 will test the hypothesis that a supervised and structure'd 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. SA4 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 mass assessed usingidual 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, c^nd 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 jn turn establish new guidelines for the Standard of Care of burned children.