Exercise and Quality of Life in Severely Burned Children

描述（由申请人提供）：严重烧伤儿童康复的现行护理标准是让患者出院，并在无人监督的环境中提供一套关于在家进行物理和职业治疗活动的书面说明。这些活动不会显著影响严重烧伤所特有的持续性和广泛性骨骼肌痉挛和无力。该补助金的中心假设是，在严重烧伤儿童出院时实施有监督和结构化的有氧和抗阻运动计划将改善身体结构和功能，从而改善生活质量（QOL）。我们提出了以下具体目标（SA）：SA 1将测试的假设，在严重烧伤的儿童，监督和结构化的运动计划将显着增加肌肉质量和骨量比目前的护理标准。SA 2将检验以下假设：在烧伤儿童中，有监督和结构化的锻炼计划将显著增加峰值有氧能力和肌肉力量，超过当前的护理标准。SA 3将检验以下假设：与当前烧伤儿童的护理标准相比，监督和结构化的锻炼计划将显著增加净蛋白质合成，并导致瘦体重和肌肉力量的改善。SA 4将检验以下假设：在烧伤儿童中，监督和结构化的运动计划将比当前的护理标准显著改善QOL。主要结果是峰值有氧能力评估。心肺运动试验;肌肉力量，采用腿部肌力测定法，肌肉质量采用牙龈X线吸收测定法评估，净蛋白平衡采用尿素富集法评估。最后，将使用儿童健康问卷（PF-28和CF-87）评估心理社会健康。将在出院时、12周运动计划结束时、烧伤后12个月和24个月时进行身体功能和QOL评估。在出院时和12周运动计划结束时进行净蛋白质平衡评估。预计这些拟议的研究将扩大严重烧伤儿童的身体和心理社会康复计划的现有知识。此外，我们相信，这些拟议的研究将产生新的和临床相关的数据，可能反过来建立新的准则，烧伤儿童的护理标准。

DESCRIPTION (provided by applicant): 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.