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Effect of exogenous growth hormone and exercise on lean mass and muscle function in children with burns
Oscar E Suman1, Steve J Thomas, Judy P Wilkins
1Shriners Hospitals for Children, Galveston TX 77550, USA. oesuman@utmb.edu
Insights
Recombinant human growth hormone (rHGH) and exercise combined did not significantly increase lean body mass (LBM) more than either alone in burned children. However, exercise was crucial for improving muscle strength.
Area of Science:
- Pediatric Endocrinology
- Rehabilitation Medicine
- Burn Injury Recovery
Background:
- Severe burns in children (>40% body surface area) often lead to muscle wasting and strength deficits.
- Recombinant human growth hormone (rHGH) is explored for its anabolic potential in recovery.
- Physical rehabilitation and exercise are key components of restoring function after burns.
Purpose of the Study:
- To investigate the combined effect of rHGH and exercise on lean body mass (LBM) and muscle strength in pediatric burn survivors.
- To compare the efficacy of combined therapy versus rHGH or exercise alone.
Main Methods:
- A randomized controlled trial involving 44 children (ages 7-17) with extensive burns (>40% BSA).
- Four groups were studied over 12 weeks: rHGH with exercise (GHEX), saline with exercise (SALEX), rHGH without exercise (GH), and saline without exercise (Saline).
- Measurements included changes in LBM and muscle strength.
Main Results:
- No significant differences in LBM increase were observed between GHEX (9.0%), SALEX (5.4%), and GH (5.8%) groups.
- Muscle strength significantly increased in the exercise groups (GHEX: 36.2%, SALEX: 42.6%) compared to non-exercise groups (GH: -7.4%, Saline: 6.7%).
- rHGH alone did not enhance muscle strength compared to saline without exercise.
Conclusions:
- Exercise is the primary driver for muscle strength recovery in pediatric burn patients.
- While rHGH may contribute to LBM changes similarly to placebo in this context, its combination with exercise does not yield superior LBM gains over exercise alone.
- Targeted exercise interventions are essential for functional rehabilitation post-burn.
Abstract:
We tested the hypothesis that the administration of recombinant human growth hormone (rHGH) and exercise would increase lean body mass (LBM) and muscle strength in burned children to a greater extent than rHGH or exercise separately. Children, ages 7-17 yr, with >40% body surface area burned, were randomized into groups. One group (GHEX, n = 10) participated in a 12-wk in-hospital physical rehabilitation program supplemented with an exercise program and received 0.05 mg. kg(-1). day(-1) of rHGH. A second exercising group (SALEX, n = 13) received saline. A third group (GH, n = 10) received a similar dose of rHGH as GHEX and participated in a 12-wk, home-based physical rehabilitation program without exercise. The fourth group (Saline, n = 11) received saline and participated in a 12-wk, home-based physical rehabilitation program without exercise. The mean (+/-SE) percent change in lean body mass after 12 wk was not significantly different between GHEX (9.0 +/- 2.1%), SALEX (5.4 +/- 1.6%), and GH (5.8 +/- 1.8%) groups (P = 0.33). However, the mean percent change in muscle strength was significantly greater in the GHEX (36.2 +/- 5.4%) and SALEX (42.6 +/- 10.0%) groups than in the GH (-7.4 +/- 4.7%) or Saline (6.7 +/- 4.4%) groups (P = 0.008). In summary, rHGH GHEX, SALEX, and GH alone produced similar improvements in LBM. However, muscle strength was only increased via exercise.