Robert P Clayton1, Paul Wurzer2, Clark R Andersen3, Ronald P Mlcak4, David N Herndon5, Oscar E Suman6. 1. Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; The Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: rpclayto@utmb.edu. 2. Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. 3. Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. 4. Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA. 5. Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; The Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. 6. Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: oesuman@utmb.edu.
Abstract
INTRODUCTION: Burns lead to persistent and detrimental muscle breakdown and weakness. Standard treatment at our institution includes a voluntary 12-week rehabilitative exercise program to limit and reverse the effects of increased muscle catabolism. In the present work, we investigated if different durations of exercise, 6 or 12 weeks, produce comparable improvements in muscle strength, body composition, and cardiopulmonary fitness. METHODS: We prospectively enrolled and randomized patients with ≥30% total body surface area (TBSA) burned to receive 6 or 12 weeks ofexercise rehabilitation. Patients were evaluated for muscle strength, oxygen consumption capacity, and lean body mass at discharge (n=42) and after exercise. After 6 weeks (n=18) or 12 weeks (n=24) of exercise training, leg muscle strength was assessed as peak torque per body weight using a Biodex isokinetic dynamometer. Oxygen consumption capacity, measured as peak VO2, was studied using a standard treadmill-based test, and lean body mass was determined using dual-energy X-ray absorptiometry. RESULTS: Significant improvements in muscle strength, peak VO2, and lean body mass were seen after 6 weeks of exercise training (p<0.001), with only significant improvements in peak VO2 being seen after 6 weeks more of training. CONCLUSION: These data suggest that a 6-week rehabilitative exercise program is sufficient for improving muscle strength, body composition, and cardiopulmonary fitness in pediatric burn patients. However, continuation of at- or near-home cardiopulmonary training following the 6 weeks of at-hospital rehabilitation may be useful.
RCT Entities:
INTRODUCTION: Burns lead to persistent and detrimental muscle breakdown and weakness. Standard treatment at our institution includes a voluntary 12-week rehabilitative exercise program to limit and reverse the effects of increased muscle catabolism. In the present work, we investigated if different durations of exercise, 6 or 12 weeks, produce comparable improvements in muscle strength, body composition, and cardiopulmonary fitness. METHODS: We prospectively enrolled and randomized patients with ≥30% total body surface area (TBSA) burned to receive 6 or 12 weeks of exercise rehabilitation. Patients were evaluated for muscle strength, oxygen consumption capacity, and lean body mass at discharge (n=42) and after exercise. After 6 weeks (n=18) or 12 weeks (n=24) of exercise training, leg muscle strength was assessed as peak torque per body weight using a Biodex isokinetic dynamometer. Oxygen consumption capacity, measured as peak VO2, was studied using a standard treadmill-based test, and lean body mass was determined using dual-energy X-ray absorptiometry. RESULTS: Significant improvements in muscle strength, peak VO2, and lean body mass were seen after 6 weeks of exercise training (p<0.001), with only significant improvements in peak VO2 being seen after 6 weeks more of training. CONCLUSION: These data suggest that a 6-week rehabilitative exercise program is sufficient for improving muscle strength, body composition, and cardiopulmonary fitness in pediatric burn patients. However, continuation of at- or near-home cardiopulmonary training following the 6 weeks of at-hospital rehabilitation may be useful.
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Authors: Christian Tapking; Daniel Popp; David N Herndon; Andrew M Armenta; Ludwik K Branski; Andrew J Murton; Oscar E Suman Journal: J Burn Care Res Date: 2019-01-01 Impact factor: 1.845