Barriers to physical activity in children with burns: A cross sectional design of child and caregiver perspectives

Miss Hannah Graham1, Ms Katherine  Alava-bravo1, Miss Nadishika Gunawardena1, Ms Stephanie Wicks2, Dr Verity  Pacey1, Dr John  Harvey3

1Department of Health Professions, Macquarie University, North Ryde, Australia, 2Physiotherapy Department, The Children’s Hospital at Westmead, Westmead, Australia, 3The Children’s Hospital Westmead , Westmead, Australia


Aims: To investigate barriers to physical activity of children and adolescents three to six months post burn injury, as perceived by the child and their caregiver. Secondary aims include comparing child and caregiver responses, and determining if a relationship exists between reported barriers and physical activity levels.

Design: Cross-sectional

Method: Children with burn injuries and their caregiver participated in the study.  Participant characteristics were recorded. Each child and caregiver completed an online questionnaire regarding barriers to physical activity. Child and caregiver scores were compared. Physical activity levels were determined using the Physical Activity Questionnaire for children (PAQ-C) and adolescence (PAQ-A).

Results: Fifteen participants aged seven to 15 years, with a mean total burn surface area of 9% (SD 11.24%) participated. Ninety-three percent of children and caregivers perceived one or more barriers to physical activity, with internal barriers more frequent than external. Fatigue (73%), fear of hurting themselves (53%) and fear of adverse scar damage (47%) were the most frequent child-reported internal barriers. Agreement between child and caregiver reported external barriers (75.15%) was greater than agreement between internal barriers (63.88%). A large negative correlation was found between number of child-reported barriers and physical activity levels (r = -0.70, p = 0.003) suggesting the greater number of perceived barriers to physical activity reported, the less physical activity undertaken.

Conclusions: Children living with burns report several barriers to physical activity, some of which specific to their burn injury. Clinicians should consider these barriers when tailoring interventions to improve physical activity levels.

I have recently completed a Doctorate of Physiotherapy at Macquarie University, Sydney. I have a strong clinical interest in optimising function and quality of life of individuals living with a traumatic injury.



ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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