Janos Cambiaso-Daniel1, Eric Rivas2, Joshua S Carson3, Gabriel Hundeshagen4, Omar Nunez Lopez5, Shauna Q Glover5, David N Herndon5, Oscar E Suman6. 1. Department of Surgery, University of Texas Medical Branch, Galveston, TX; Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. 2. Department of Surgery, University of Texas Medical Branch, Galveston, TX; Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX. 3. Shands Burn Center, Department of Surgery, University of Florida, Gainesville, FL. 4. Department of Surgery, University of Texas Medical Branch, Galveston, TX; Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX; BG Trauma & Burn Center, Department of Hand, Plastic and Reconstructive Surgery, University of Heidelberg, Ludwigshafen, Germany. 5. Department of Surgery, University of Texas Medical Branch, Galveston, TX; Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX. 6. Department of Surgery, University of Texas Medical Branch, Galveston, TX; Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX. Electronic address: ravi.jhaveri@unc.edu.
Abstract
OBJECTIVES: To compare physical capacity and body composition between children with burn injuries at approximately 4 years postburn and healthy, fit children. STUDY DESIGN: In this retrospective, case-control study, we analyzed the strength, aerobic capacity, and body composition of children with severe burn injuries (n = 40) at discharge, after completion of a 6- to 12-week rehabilitative exercise training program, and at 3-4 years postburn. Values were expressed as a relative percentage of those in age- and sex-matched children for comparison (n = 40 for discharge and postexercise; n = 40 for 3.5 years postburn). RESULTS: At discharge, lean body mass was 89% of that in children without burn injuries, and exercise rehabilitation restored this to 94% (P < .01). At 3.5 years postburn, lean body mass (94%), bone mineral content (89%), and bone mineral density (93%; each P ≤ .02) remained reduced, whereas total body fat was increased (148%, P = .01). Cardiorespiratory fitness remained lower in children with burn injuries both after exercise training (75%; P < .0001) and 3.5 years later (87%; P < .001). Peak torque (60%; P < .0001) and average power output (58%; P < .0001) were lower after discharge. Although exercise training improved these, they failed to reach levels achieved in healthy children without burns (83-84%; P < .0001) but were maintained at 85% and 82%, respectively, 3.5 years later (P < .0001). CONCLUSIONS: Although the benefits of rehabilitative exercise training on strength and cardiorespiratory capacity are maintained at almost 4 years postburn, they are not restored fully to the levels of healthy children. Although the underlying mechanism of this phenomenon remains elusive, these findings suggest that future development of continuous exercise rehabilitation interventions after discharge may further narrow the gap in relation to healthy adolescents. Published by Elsevier Inc.
OBJECTIVES: To compare physical capacity and body composition between children with burn injuries at approximately 4 years postburn and healthy, fit children. STUDY DESIGN: In this retrospective, case-control study, we analyzed the strength, aerobic capacity, and body composition of children with severe burn injuries (n = 40) at discharge, after completion of a 6- to 12-week rehabilitative exercise training program, and at 3-4 years postburn. Values were expressed as a relative percentage of those in age- and sex-matched children for comparison (n = 40 for discharge and postexercise; n = 40 for 3.5 years postburn). RESULTS: At discharge, lean body mass was 89% of that in children without burn injuries, and exercise rehabilitation restored this to 94% (P < .01). At 3.5 years postburn, lean body mass (94%), bone mineral content (89%), and bone mineral density (93%; each P ≤ .02) remained reduced, whereas total body fat was increased (148%, P = .01). Cardiorespiratory fitness remained lower in children with burn injuries both after exercise training (75%; P < .0001) and 3.5 years later (87%; P < .001). Peak torque (60%; P < .0001) and average power output (58%; P < .0001) were lower after discharge. Although exercise training improved these, they failed to reach levels achieved in healthy children without burns (83-84%; P < .0001) but were maintained at 85% and 82%, respectively, 3.5 years later (P < .0001). CONCLUSIONS: Although the benefits of rehabilitative exercise training on strength and cardiorespiratory capacity are maintained at almost 4 years postburn, they are not restored fully to the levels of healthy children. Although the underlying mechanism of this phenomenon remains elusive, these findings suggest that future development of continuous exercise rehabilitation interventions after discharge may further narrow the gap in relation to healthy adolescents. Published by Elsevier Inc.
Entities:
Keywords:
body composition; exercise program; muscle strength; peak aerobic capacity; rehabilitation; standard of care
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