Blome-Eberwein, Sigrid A, MD

Dideon-Hess, Elizabeth, LSW

Miller, Christina, PT, DPT

Tremblay, Sandra M, PT, MS, CWS, MSCS

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of SurgeryYoga for Burn Survivors: Impact on Range ofMotion, Cardiovascular Function and Quality ofLifeChristina Miller PT, DPTLehigh Valley Health NetworkSandra M. Tremblay PT, MS, CWS, MSCSLehigh Valley Health Network, Sandra.Tremblay@lvhn.orgElizabeth Dideon-Hess LSWSigrid A. Blome-Eberwein MDLehigh Valley Health Network, sigri.blome-eberwein@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/surgeryPart of the Other Medical Specialties Commons, and the Surgery CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtMiller, C., Tremblay, S., Dideon-Hess, E., & Blome-Eberwein, S. (2015, April 23). Yoga for Burn Survivors: Impact on range of motion,cardiovascular function and quality of life. Poster presented at the American Burn Association 47th Annual Meeting, Chicago, IL.Lehigh Valley Health Network, Allentown, PAYoga for Burn Survivors: Impact on Range of Motion, Cardiovascular Function            and Quality of lifeChristina Miller, PT DPT, Sandra M. Tremblay, PT DPT CWS, Elizabeth Dideon-Hess, LSW, Sigrid A. Blome-Eberwein, MD© 2015 Lehigh Valley Health NetworkBackground and Purpose:As medical management of burns has improved, the survival rate has increased leading to a paradigm shift of examining the long-term outcomes in a burn injury. Post burn survivors often experience a decline in physical function after a burn injury, including decreased strength, cardiovascular endurance, joint range of motion and flexibility.  This case series study examined the effects of a yoga practice on range of motion, cardiovascular function and quality of life of people after burn injury. Methods: •  Subjects: 5 participants 	 	 –		Median age: 61	 	 	 –		TBSA: 5%-65%	 	 	 –		Hospital Length of Stay: 10 days- 4 months with bedrest and surgical interventions  •  Yoga Intervention: 60 minute classes, 2 times per week for 8 weeks 	 	 –		All classes included a warm-up, hatha yoga, pranayama, and meditation	 	 	 –		Classes were performed by a trauma certified yoga instructorABSTRACT:Objective: To characterize the use of the new commercial tests for aneuploidy screening using cell-free fetal DNA (cffDNA) by women at high risk for fetal aneuploidy.Study Design: This is a retrospective cohort study of all women undergoing cffDNA testing in the first 6 months the tests were offered in the Lehigh Valley Health Network Maternal Fetal Medicine practice. All patients were high risk for fetal aneuploidy defined as advanced maternal age, abnormal aneuploidy screening, abnormal ultrasound findings and/or personal/family history. Medical records were reviewed for patient demographics, indication for testing, other tests performed, pregnancy outcomes (maternal and fetal) and insurance information.Results: A total of 142 patients underwent cffDNA testing from 1/1/12 to 6/30/12. The mean age of patients having the test performed was 32.3 ± 6.5 years. Most patients were Caucasian (72%), non-hispanic (83%), multiparous (64%), married (58%), had private obstetrician (77%), had private insurance (51%) and were singleton gestations (95%). The median gestational age the test was performed was 18 5/7 weeks (range 10 2/7 – 28 3/7). Most tests were performed in the second trimester (73%). Insurance coverage varied and evolved significantly during this time period. Four patients had positive test results (3%) and three had uninformative results (2%). There was one false negative and there were no false positives. Sensitivity, specificity, positive predictive value and negative predictive value were 80%, 100%, 100% and 99%, respectively.Conclusion: Our study provides some information on the use of new commercial tests for aneuploidy screening using cffDNA in clinical practice in a non-research setting. Although the potential for these tests to provide women with information regarding their pregnancies without the risk of an invasive procedure is exciting, additional studies are needed to validate their performance in both low and high risk populations, and providers and patients need to be aware of their limitations.DISCUSSION:Burn survivors, like others with critical illness and prolonged intensive care stays, experience decreased exercise capacity and weakness, in addition to the joint, muscular and skin limitations specific to burn.  The results of this pilot study suggest that cardiovascular function can be improved with a 60-minute yoga intervention two times per week for eight weeks.  This study also demonstrated a significant improvement in the functional score of the quality of life measure, as well as a significant improvement in the emotional score of the quality of life in these 5 participants.  Anecdotal evidence suggests improved range of motion in our participants.  Further research is necessary to evaluate the effectiveness of yoga in burn survivors. Outcomes: •  Cardiovascular 	 	 –		Significantly improved 6 Minute Walk Test distances (Figure 1)	 	 	 –		Improved Oxygen Consumption (VO2 Max) post intervention (Figure 2)  •  ROM Changes: Four of five of the participants had improvements in their burn joints.  Remarkably even those participants who were 4,5, and even 12 years post-burn demonstrated 10-15 degrees improvement in their Active Range of Motion of some of their burn joints. •  Quality of Life: 	 	 –		A generalizable significant improvement in the SF36 Functional Score (Figure 3) 	 	 	 –		A non-generalizable significant improvement in the SF36 Emotional Score (Figure 4) •  Interesting to note that for every subscale score, with the exception of the physical functioning subscale score, the highest score occurred during phase 2200300400500600DistanceTraveled(inmeters)1Phase2 3Average Distance Traveled During the 6 Month Walk Test by Phase13.514.515.015.516.5VO2Max1Phase2 3Average VO2 Max After 6 Minute Walk Test for Each Phase13.52315.39216.41316.014.04050556070Score1Phase2 3Average Physical Functioning Subscale Score by Phase41.222587065455060708090Score1Phase2 3Average Role Limitations Due to Emotional Problems SubscaleScore by Phase7593.33350Figure	4.	Average Role Limitations Due to    Emotional Problems Subscale Score by PhaseFigure	3.	Average Physical Functioning Subscale Score by PhaseFigure	1.	Average Distance Traveled During  the 6 Minute Walk Test by PhaseFigure	2.	Average VO2 Max After 6 Minute Walk Test for Each Phase

Yoga for Burn Survivors: Impact on Range of Motion, Cardiovascular Function and Quality of Life

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1709&context=surgery

Yoga for Burn Survivors: Impact on Range of Motion, Cardiovascular Function and Quality of Life

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