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Published on: February 23, 2024
Children's growth and motor development following a severe burn: a systematic review
Maxime D Cuijpers1,2,3, Martin G A Baartmans4, Paul P M van Zuijlen1,2,5,6
1Red Cross Hospital, Burn Centre Beverwijk, Vondellaan 13, Beverwijk, The Netherlands.
Insights
Pediatric burn survivors show initial declines in growth and motor development, with recovery noted within two years. However, severe burns (≥30% TBSA) can cause lasting impacts on muscle, bone, and lean body mass.
Area of Science:
- Pediatric Burn Research
- Developmental Pediatrics
- Rehabilitation Medicine
Background:
- Epidemiological data on post-burn growth, body composition, and motor development in children is inconsistent.
- A comprehensive understanding of these long-term effects is crucial for effective patient management.
Purpose of the Study:
- To systematically review and synthesize existing evidence on growth, body composition, and motor development in pediatric burn patients.
- To identify trends and persistent effects following burn injuries in children.
Main Methods:
- A systematic literature search was performed across PubMed, EMBASE, and Web of Science up to March 2021.
- Included studies were observational, focusing on pediatric burn patients with quantitative metrics on growth, body composition, or motor development.
- Sixteen studies, involving 2022 pediatric burn patients (mean age 7.7 years, average burn size 52.8% TBSA), were analyzed.
Main Results:
- Outcome measures included weight, height, muscular strength, bone mineral content/density, body mass index, fat mass, lean body mass, and motor development.
- Most studies focused on patients with severe burns (≥30% TBSA).
- Weight and height showed initial decline followed by recovery, while muscular strength, bone mineral content, and lean body mass were significantly impacted long-term.
Conclusions:
- While some recovery in growth and motor development is observed within 1-2 years post-burn, severe burns can lead to prolonged deficits in muscular strength, bone mineral content, and lean body mass.
- Findings may not be generalizable to all pediatric burn populations due to the focus on severe burn cases.
- Further research is needed to understand the full spectrum of developmental impacts across varying burn severities.
Background:
The epidemiological data on post-burn growth, body composition and motor development is ambiguous and scattered. The aim of this systematic review was therefore to summarize the current body of evidence on post-burn growth, body composition and motor development in children.
Methods:
A literature search was conducted in PubMed, EMBASE and Web of Science up to March 2021. We considered observational studies that reported (1) metrics on weight, height, body composition, bone mineral content, bone mineral density or motor development, in (2) paediatric burn patients and (3) published in a peer-reviewed journal.
Results:
A total of 16 studies were included. Each of the included studies used quantitative methods, but with differing methodology: prospective cohort studies (n = 8), retrospective chart reviews (n = 3), case-control studies (n = 2), cross sectional studies (n = 2) and a retrospective cohort study (n = 1). When combined, the included studies represented 2022 paediatric burn patients, with a mean age of 7.7 (±3.2) years. The average burn size was 52.8% (±12.7) of the total body surface area. Identified outcome measures included weight (n = 12), height (n = 7), muscular strength (n = 4), bone mineral content (n = 5), bone mineral density (n = 5), body mass index (n = 3), fat mass (n = 5), lean body mass (n = 7) and fine and gross motor development (n = 1).
Conclusions:
Following an initial decline, patients' growth and motor development started to recover during the first or second year post-burn. Nonetheless, burns may have a profound and prolonged effect on the paediatric burn patients' muscular strength, bone mineral content and lean body mass. It should be noted that the vast majority of studies included only patients with burns covering ≥30% total body surface area. The evidence presented in this review may thus not be representative of the whole paediatric burn population.
