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Shriners of North
America
Last modified: 10/26/06
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Welcome to the Pediatric Burn Injury
Rehabilitation Model System administered by UTMB and Shriners Burn
Hospital in Galveston, Texas.
In 1993,
The National Institute on Disability and
Rehabilitation Research (NIDRR) sponsored three burn injury
model systems for a period of four years. In 1997, NIDRR
enhanced
the above priorities to include children.
Now, there are four
Burn Injury Rehabilitation Model
Systems
in the United States:
Johns
Hopkins University - Bayview Medical Center
University of Texas Medical Branch - Shriners
Burn Hospital
University
of Texas - Southwestern Medical Center at Dallas
University
of Washington - Harborview Medical Center
NIDRR funds these Burn Injury Rehabilitation Model Systems at
four Centers of Excellence. The purpose of the program is to
study and characterize the outcome of burn injury with particular
attention to improving the rehabilitation of burn survivors, including
children. In addition, a national burn outcome data center is funded at
the University of Colorado, Denver, Colorado.
It is called the
Burn Model System Projects Database Coordination
Center.
The UTMB project improves outcomes for severely burned children by instituting
and evaluating two modifications to traditional rehabilitation: (1) an
intensive inpatient rehabilitation program including active resistance
exercise; (2) long term administration of anabolic agents.
Effectiveness is assessed by comparison with functional outcomes achieved
in traditional outpatient rehab. programs. Results indicate improvement in
strength, endurance and bone density with these modifications. The
project also assesses use of pressure to subdue the effects of scar formation.
The project's Community Reintegration Program operates in conjunction with
outreach clinics and school reintegration programs. The project
also maintains a longitudinal database that includes measures of
cardiopulmonary function,
growth and maturation, bone density, range of motion, reconstructive needs
and psychosocial adjustment. This data is part of the
national database, as well as being used for local data
analyses.
The UTMB Burn Model System program in the Shriners Burn
Hospital has accomplished some
important goals. The intensive and inclusive rehabilitation program
should be noted as the cornerstone achievement of this model systems
project, for it promises to improve the lives of young survivors of
massive burn injuries in many dramatic ways. The pressure garment
study also promises to have dramatic and revolutionary impact upon burn
care. If results continue as they have to date, and strong pressure
seems to make no difference in the outcome of much of the resultant
scarring, the discomfort of burned children and the discord caused in
families of burned children around the issue of compliance will be greatly
diminished.
The finding of diminished social skills among pediatric burn
survivors has pointed us in the direction of an important intervention
that we are now testing in a separate study of adolescent survivors who
are 'troubled'. We have also contributed importantly to the overall
study of burn care and rehabilitation by adding to the national database.
We have supplied data on 357 patients, accounting for at least 40% of the
pediatric patient data in the database. Collectively with the other
Burn Model Systems, we are reaching the point of having enough pediatric
data to answer important questions heretofore unanswerable because of
limitations of site-specific sample sizes.
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