Effectiveness of resistance strength training in children and adolescents with ≥30% total body surface area: A systematic review

Abstract

PurposeChildren and adolescents with burn injuries are at risk of living with social, educational, physical and psychological impairments. The systematic review aimed to ascertain the effectiveness of resistance strength training on muscle strength and lean body mass (LBM) in children and adolescents with burn injuries.MethodFive databases were searched. Randomised controlled trials with an intervention defined as a supervised, individualised resistance exercise programme were sought. The outcomes included muscle strength and/or LBM. The PEDro scale was used to describe the methodological quality. Comparable data were combined using RevMan©.ResultsSeven papers were included in the review with an average methodological appraisal score of 5.7/11. Comparable data were combined for muscle strength and LBM. The meta-analysis revealed no significant clinical difference between the exercise and standard care groups after 3 months of strength training for both muscle strength (p = 0.43) and LBM (p = 0.60).ConclusionsThere is no conclusive evidence to support the benefit of strength training for children and adolescents with burns injuries in terms of muscle strength and LBM. However, it appears that isokinetic training might benefit children and adolescents with burns, but more studies investigating the effect of isokinetic training are required.

A systematic review protocol on the effectiveness of therapeutic exercises utilised by physiotherapists to improve function in patients with burns

“…In selecting studies, we will apply the following criteria: Participants Studies of human participants of any age suffering from burns will be eligible, and there will be no restriction on total body surface area (TBSA) affected or duration of intervention to cater for both long- and short-term outcomes in terms of exercise prescription [ 10 ]. Both males and females will be considered for the review even though exercise tolerance may differ [ 11 ]. Animal studies will be excluded due to their different anatomical structure hence difficulty in exercise prescription.…”

“…The main goal of therapeutic exercises is to return the injured patient to a fully functioning pain-free state [ 8 , 9 ]. Therapeutic exercises may include strengthening, endurance, flexibility, balance and coordination exercises [ 10 , 11 ].…”

“…Exercise is beneficial, not only for patients with burns but also for healthy patients [ 10 ]. The beneficial effects of exercise are improved cardiovascular health, maintaining a healthy weight, improving bone weight, improvement in self-confidence and social skills [ 10 , 11 ]. Exercise prescription might be beneficial for patients with burns as they are at an increased risk of bed immobility due to heavy sedation from pain medication, constant wound dressing and bandaging.…”

“…It concluded that stretch on its own was not effective in preventing contractures. There have been studies done on the effect of exercise, but the two [ 10 , 11 ] systematic reviews could be found in the Cochrane database, the Prospero database or PEDro respectively which examined the effect of exercise did not target exercise prescription for burn patients. There is evidence that exercise might reduce the impact of secondary complications of burns [ 18 ], such as muscle weakness and decreased anaerobic capacity, and be as effective as splinting in retaining range of motion of the shoulder after axillary burns [ 19 ] and there is thus a need for guidelines, especially those that can be implemented in low-income settings.…”

“…Most of the interventions were developed for first world countries [ 2 , 10 , 11 ] but may not be applicable to Africa where most of the countries have resource constraints with regard to health care provision. Examples of this include lack of specialised staff, lack of state of the art equipment and lack of dedicated burn units in medical facilities.…”