Cardiovascular fitness of children and adolescents following lower limb burn injury: A cross sectional study

Mrs Katherine Alava Bravo1, Ms Stephanie Wicks1,2, Miss Hannah Graham1, Miss Nadishika  Gunawardena1, Dr Verity Pacey1,3

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

Aim: To assess the cardiovascular fitness of children and adolescents post lower limb burn injury and determine if burn location affects performance.

Methods: Participant characteristics and burn location were recorded. The six minute walk test was used to measure cardiovascular fitness. Physical activity levels were determined using the Physical Activity Questionnaire for children (PAQ-C) and adolescence (PAQ-A). Overall results were compared to contemporary normative data and participant results of different burn locations were also compared using unpaired t tests.

Results: Twenty six participants (76.9% male) aged five to 16 years (mean: 10.4 years, SD: 3.21), were assessed at a mean of 125 days post burn injury. Total body surface area of burns ranged from 0.7% to 30% (mean 5.41%, SD: 6.99%). Nine participants had bilateral injuries. Ten participants had burns crossing a joint surface. Performance was significantly reduced overall on the six minute walk test compared to normative data (mean difference -90.49 metres, 95% CI -143.87 to -37.11, p = 0.001) .  Burn location did not significantly alter performance (all p<0.38).  Participants PAQ scores ranged from 0 – 4.58/5 (mean 2.98, SD 1.30) suggesting high variability in the physical activity levels of children with burns. A moderate non-significant correlation was found between physical activity levels and six minute walk distance (r2=0.43, p=0.05).

Conclusion: Cardiovascular fitness is reduced in children and adolescents 3 – 6 months post lower limb burn injury, irrespective of burn location. Physiotherapy interventions should focus treatment on reconditioning to address these impairments.

Accredited Exercise Physiologist and Doctor of Physiotherapy student with an interest in Paediatrics

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