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Effect of exercise training on pulmonary function in children with thermal injury
Oscar E Suman1, Robert P Mlcak, David N Herndon
1Medical Staff Administration, Shriners Hospitals for Children, Department of Surgery, The University of Texas Medical Branch, Galveston, Texas 77550, USA.
Insights
Exercise training significantly improved pulmonary function in severely burned children (BC). This suggests exercise should be a core part of rehabilitation for pediatric burn survivors, enhancing recovery and long-term health outcomes.
Area of Science:
- Pediatric critical care
- Rehabilitation medicine
- Respiratory physiology
Background:
- Severe thermal injuries in children lead to persistent pulmonary dysfunction.
- Exercise is known to improve pulmonary function in other patient groups.
- The impact of exercise on pulmonary function in pediatric burn survivors is not well understood.
Purpose of the Study:
- To determine if a structured exercise program improves pulmonary function in severely burned children.
- To compare the effects of exercise-inclusive rehabilitation versus standard rehabilitation in this population.
Main Methods:
- A 12-week study involving severely burned children (ages 7-18, >40% total body surface area burned) and healthy controls.
- Burned children were randomized into an exercise-enhanced rehabilitation group (REX) or a non-exercise rehabilitation group (R).
- Pulmonary function tests were conducted at baseline and post-intervention for REX and R groups.
Main Results:
- Burned children exhibited reduced pulmonary function compared to healthy controls at baseline.
- The exercise-enhanced rehabilitation group (REX) showed significant improvements in pulmonary function.
- The non-exercise rehabilitation group (R) demonstrated minimal changes in pulmonary function.
Conclusions:
- Exercise training is effective in improving pulmonary function in severely burned children.
- Incorporating exercise into rehabilitation programs is crucial for pediatric burn survivors.
- Exercise should be a fundamental component of multidisciplinary outpatient treatment for thermal injury victims.
Abstract:
Severe thermal injury in children results in a decrease in pulmonary function (PF) which lasts well into convalescence. Exercise has been used successfully to improve PF in other populations exhibiting a compromised PF such as in chronic obstructive pulmonary disease. Yet, whether exercise training will induce improvements in PF in burned children is presently unknown. We therefore evaluated if an exercise program improved PF in severely burned children (BC). Twenty healthy controls, nonburn children (NB) age 7 to <18 and 31 severely burned children; ages 7 to <18 years old, with greater than 40% of total body surface area burned were enrolled in the study. Burned children were randomized into two groups. One to participate in a 12-week in-hospital physical rehabilitation program supplemented with an exercise-training program (REX, n = 17) and the other nonexercising group (R, n = 14) to participate in a 12-week, home-based physical rehabilitation program without exercise. Pulmonary function tests were performed for all groups at baseline, but only the REX and R groups were tested after 12 weeks of either exercise or no exercise. Baseline PF for the NB group was normal and no differences in PF were found between the R vs REX groups. However, PF was decreased in BC compared to NB children. There was a significant improvement in PF in the REX group. In contrast, PF in the R group remained relatively unchanged. Severely burned children improve PF as a result of an exercise program and such should be a fundamental component of a multidisciplinary outpatient treatment program for victims of thermal injury.