Children's growth and motor development following a severe burn: a systematic review

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.