The interdisciplinary team who follow the children through their physical growth and psychological development are continuously striving to meet the challenges of complex burn-related problems for the growing child and developing adolescent, as well as for the families of children so injured.
Members of this team come from several clinical areas:
Responsibilities of the Child Life Staff:
Customer Service Area:
Shriners Burns Hospital has a staff of mental health experts who follow every child and family from the time of admission to eventual discharge from the Shriners system - i.e. through the acute admission, as outpatients during clinic visits, and through subsequent admissions until the child is 21 years old or no longer needs our services.
We also have 1 or more psychology residents at any given time. A full-time school teacher provides schooling for every school-aged child as soon as they are able to participate, either at bedside or in the classroom on the 4th floor. Additionally, a professional counselor works mostly with clinical research, but will occasionally be involved clinically with a patient or family.
Much consideration must be given to a program of rehabilitation for the burn patient, and every patient needs an individually tailored plan of care. There are 4 principles for the rehabilitation of the burn patient:
The program should start
early, preferably the day of injury.
In February of 2000, the National Institute on Disability and Rehabilitation Research (NIDRR) awarded Dr. David N. Herndon, Chief of Staff, a five-year grant.
One of the principal aims of the grant is to investigate the effect that a three-month exercise program has on muscle strength in children with burn injuries. In conjunction with exercise training, therapeutic drug interventions such as the administration of anabolic agents, will also be studied.
Evidence strongly suggests that exercise is beneficial in the rehabilitation of many physical injuries and diseases. It is also believed that exercise will significantly improve the functional outcome of patients who have suffered severe burns. However, this has not been substantiated in a well designed, randomized scientific study.
For this purpose, the Children’s Wellness Center was created. It is a 500 square foot facility fully equipped with strength and aerobic exercise equipment for use by the patients participating in the NIDRR grant. The staff of the Wellness center is responsible for the implementation of the individualized exercise-training program and exercise testing of all patients involved in the NIDRR study.
To date, more than 200 patients have been tested and approximately 60 patients have completed the exercise-training program. Results were extremely positive. Patients that participate in the exercise program increase muscle function and cardiopulmonary endurance significantly more than patients that did not participate in the three-month exercise-training program.
Dr. Oscar E. Suman, associate professor at the University of Texas Medical Branch and director of the Children’s Wellness Center at Shriners Hospital for Children, is quick to point out that “It is important to remember that exercise training alone is not a substitute for traditional physical and occupational rehabilitation care. The benefits of exercise are probably additive and not independent of traditional physical and occupational therapy.”
The Children’s Wellness Center will continue to participate in this and other federal and non-federal clinical research studies in which the effects of exercise alone or in combination with various medical interventions are assessed.
Finally, the translation of research to clinical practice is reflected in the fact that exercise as a regular clinical therapeutic modality at the Galveston Hospital for patients age 7 and older, and with greater than 40% total body surface area burned, is starting to be implemented. The implementation of such exercise as cardiopulmonary and skeletal muscle rehabilitation (CPMR) is offered through the Children’s Wellness and Exercise Center under the direction of Dr. Oscar Suman.
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