Effects of a hospital based Wellness and Exercise program on quality of life of children with severe burns

Rosenberg, Marta; Celis, Mario M.; Meyer, Walter J.; Tropez-Arceneaux, Lisa L; McEntire, Serina J.; Fuchs, Helen; Richardson, Lisa; Hölzer, Charles E.; Herndon, David N.; Suman, Oscar E.

doi:10.1016/j.burns.2012.08.019

Cited by 36 publications

(29 citation statements)

References 50 publications

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“…A limitation of our current study is that we have not assessed psychosocial well-being or home-based exercise activities. Recent work from our institution showed that exercise positively affects psychosocial outcomes (14). Here we describe data on only exercise performance or capacity, as this was the sole focus of the current study and our major interest.…”

Section: Discussionmentioning

confidence: 99%

Long-term effects of physical exercise during rehabilitation in patients with severe burns

Wurzer

Voigt

Clayton

et al. 2016

Surgery

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Background We have reported that a 12-week exercise program is beneficial for the exercise performance of severely burned children. However, it is not known whether the beneficial effects remain at 2 years post burn. Methods Severely burned children who received no long-term anabolic drugs were consented to this IRB-approved study. Patients were able to choose between a voluntary exercise program (EX-group) and no exercise (NoEX-group) after discharge from the acute burn unit. Peak torque per lean leg mass (PTLLM), maximal oxygen consumption (VO2max) and percent predicted peak heart rate (%PPHR) were assessed. In addition, BMI percentile (BMI%) and lean body mass index (LBMI) were recorded. Both groups were compared for up to 2 years post burn using mixed multiple analysis of variance, and the level of significance was defined at p<0.05. Results One hundred twenty-five patients with a mean age of 12±4 years were analyzed. Demographics between the EX-group (N=82) and NoEX-group (N=43) were comparable. In the EX-group, PTLLM, %PPHR, and VO2max increased significantly with exercise (p<0.01). Between discharge and 12 and 24 months, BMI% increased significantly in the EX-Group (p<0.05) but did not change in the NoEX-group. There were no significant differences between groups in BMI%, LBMI, PTLLM, and VO2max at 24 months post burn. Conclusions Exercise significantly improves physical performance of burned children. However, the benefits are limited to early time points and become greatly narrowed with further recovery time. Continued participation in exercise activities or a maintenance exercise program is recommended for exercise-induced adaptations to continue.

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Section: Discussionmentioning

confidence: 99%

Long-term effects of physical exercise during rehabilitation in patients with severe burns

Wurzer

Voigt

Clayton

et al. 2016

Surgery

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“…The hypermetabolic response augments proteolysis to cause loss of lean body mass, which is exacerbated by prolonged physical inactivity [5]. The resulting morbidity inhibits patients‘ return to normal societal activities and reduces quality of life [6]. One strategy that has proven effective in combating decreased lean body mass, reduced muscle strength, and reduced cardiopulmonary fitness is physical exercise [7–9].…”

Section: Introductionmentioning

confidence: 99%

Effects of different duration exercise programs in children with severe burns

Clayton

Wurzer

Andersen

et al. 2017

Burns

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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 post 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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“…In general, we know from outcome research that the majority of pediatric burn survivors achieve optimal long-term outcomes, but many continue to have long-term physical and psychological needs [10–17]. We also know that participation in a structured exercise and rehabilitation program can improve physical, respiratory, and emotional functioning for pediatric burn survivors [22–24]. Unfortunately, not much was previously known about the perceived long-term psychological outcome of pediatric burn survivors with inhalation injury.…”

Section: Discussionmentioning

confidence: 99%

Comparison of long-term quality of life of pediatric burn survivors with and without inhalation injury

Rosenberg

Ramirez

Epperson

et al. 2015

Burns

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Objective To examine the long-term quality of life of pediatric burn survivors with and without inhalation injuries. We hypothesized that patients with inhalation injury would report more disability and lower quality of life. Methods We examined 51 patients with inhalation injury and 72 without inhalation injury who had burns of ≥10% total body surface area, were age ≥16 years at time of the interview, and were greater than 5 years from injury. Subjects completed the World Health Organization Disability Assessment Scale II (WHODAS II) and the Burn Specific Health Scale-Brief (BSHS-B). Multiple regression analyses were used to measure the effects of inhalation injury while controlling for age at burn and TBSA. Results The mean age of burn of participants with inhalation injury was 11.7 ± 3.6 years, mean TBSA 55% ± 18, and mean ventilator days 8.4 ± 9. The mean age of burn of participants without inhalation injury was 10.3 ± 34.1 years, mean TBSA 45% ± 20, and mean ventilator days 1.3 ± 5.2. Inhalation injury did not appear to significantly impact participants' scores on the majority of the domains. The WHODAS II domain of household activities showed a significant relation with TBSA (p = 0.01). Increased size of burn was associated with difficulty completing tasks for both groups. The BSHS-B domain of treatment regimen showed a relation with age at burn (p = 0.02). Increased age was associated difficulty in this area for both groups. Conclusions Overall the groups were comparable in their reports of disability and quality of life. Inhalation injury did not affect long-term quality of life.

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Effects of a hospital based Wellness and Exercise program on quality of life of children with severe burns

Cited by 36 publications

References 50 publications

Long-term effects of physical exercise during rehabilitation in patients with severe burns

Long-term effects of physical exercise during rehabilitation in patients with severe burns

Effects of different duration exercise programs in children with severe burns

Comparison of long-term quality of life of pediatric burn survivors with and without inhalation injury

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