Balance and strength of children and adolescents with lower limb burns: A cross-sectional study

Mrs Nadishika Gunawardena1, Mrs Kathy  Alava-Bravo1, Miss Hannah Graham1, Dr Verity  Pacey1,2, Ms Stephanie  Wicks2, 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 at Westmead, Westmead, Australia


Aim: To investigate balance skills of children and adolescents 3 to 6 months post a lower limb burn injury in comparison to normative data. The study also aims to determine whether burn size or location alter performance.

Design: Cross-sectional study

Method: Total body surface area of the burn and burn location were recorded. The BOT-2 balance subsection and the star excursion balance test assessed balance. The 30-second chair rise test was used to measure lower limb strength. Results were compared to normative data and unpaired t-tests compared children with different burn locations.

Results: Twenty-five participants (mean age 10.22 years) were assessed at a mean 126 days post burn. Total body surface area of the burns ranged from 0.7% to 30% (median 4%) with 9 participants having bilateral involvement and 10 participants with burns crossing lower limb joints. Balance skills were unaffected with no significant difference on the star excursion balance test in comparison to normative data (mean difference 3.82% leg length, 95%CI -10.31 to 17.94) and 22 of the 25 participants scored average or above average category on the BOT-2 balance subscale. Lower limb strength was significantly reduced on the 30-second chair rise test compared to normative data (mean difference -5.94 repetitions, 95%CI -8.34 to -3.53). Burn location did not significantly alter performance on any of these measures (all p> 0.05).

Conclusions: Lower limb strength, but not balance, is reduced in children 3- 6 months post lower limb burn injury. Burn location or size does not alter performance.

I am a third year physiotherapy student from Macquarie University who is enrolled in the Doctor of Physiotherapy program. I am planning to graduate in July 2017. I have a strong interest in paediatrics, specifically an interest in children who had a traumatic injury.

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