Pain, Exercise and Psychological Well-being in Pectus Excavatum

Study Overview
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Brief Summary
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Recovery following major surgical procedures can be influenced by both physical (optimization of cardiopulmonary function, pain control, activity) and psychological factors. Physical activity recommendations for post-operative patients is difficult, in part because little is known about the short- and long-term benefits of exercise and mobility on post-operative pain and return to normal functioning.

Detailed Description
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Major surgery has a drastic impact on the lives of patients and their families. Often, patients undergoing the Nuss procedure have lingering pain which can complicate recovery. Depending on the nature of the surgery and the severity of disease, this recovery period can be as short as a few days, or it can take several weeks and even months. Few studies have demonstrated the benefit of physical activity and exercise postoperatively on returning to normal function. Additionally, research has suggested that pain and recovery can be influenced by psychological factors. The investigators will use wireless activity monitors to assess the activity levels of children who undergo major musculoskeletal surgery, specifically the Nuss procedure. The investigators will also evaluate this population for psychological well-being. In this pilot study, the investigators identify goals and objectives which will provide preliminary evidence for physical and psychological recommendations to reduce post-operative pain and improve recovery. Families will be asked to complete questionnaires at different phases in the surgery (pre-surgery, post bar insertion, post bar removal). Children will be instructed to record any pain they are experiencing as a result of their condition or the surgery at various time points. The activity levels will also be followed over the course of the recovery period.

Official Title
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Evaluating Outcomes for Pectus Excavatum: Pain, Exercise, and Psychological Well-being

Conditions
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Pectus Excavatum

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children between the ages of 12-18 years that are scheduled to undergo a surgical procedure for the correction of pectus excavatum Exclusion Criteria: History of chronic pain disorders History of major mental illness such as psychosis or bipolar disorder Cognitive impairment significantly below average age and/or grade level Non-English speaking parent or child Unable to obtain and keep access to a cellular phone Loss of wireless electronic activity monitor and refusal to replace to remain in the study

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| pectus excavatum surgical candidates<br>Any person who is eligible to undergo the Nuss procedure for surgical correction of pectus excavatum | Other: No intervention<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvement in pain scores | pain diary and self report via questionnaires | change from baseline (2 weeks prior to bar insertion) to post bar removal surgery (3 years, 3 months) | 
| Increase in activity level/exercise | wireless activity monitor and physical therapy notes | change from baseline (2 weeks prior to bar insertion) to post bar removal surgery (3 years, 3 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mood | child self report and parental report via questionnaires | change from baseline (2 weeks prior to bar insertion) to post bar removal surgery (3 years, 3 months) | 
| body image | child self report and parental report via modified Y-BOCS ; increased scores mean worse body image | change from baseline (2 weeks prior to bar insertion) to post bar removal surgery (3 years, 3 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sunken chest, caved-in chest, chest deformity, sunken sternum