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Effect of Exercise Training on the Frequency of Contracture-Release Surgeries in Burned Children
Jong O Lee1, David N Herndon, Clark Andersen
1From the *Department of Surgery, University of Texas Medical Branch; and †Shriners Hospitals for Children-Galveston, Galveston, TX.
Insights
Intensive physical exercise (IPE) may reduce the need for repeat surgeries in children with extensive burns. This approach showed a significant decrease in contracture release procedures for burn survivors who participated in IPE.
Area of Science:
- Pediatric burn rehabilitation
- Surgical outcomes in pediatric burns
Background:
- Intensive physical exercise (IPE) improves physical function in pediatric burn survivors.
- The impact of IPE on the frequency of contracture-releasing procedures is not well-established.
Purpose of the Study:
- To determine if intensive physical exercise (IPE) reduces the need for repeat contracture-releasing surgeries in children with extensive burns.
Main Methods:
- Reviewed surgical records of 184 children (≥7 years, ≥40% total body surface area burns) who had contracture release procedures.
- Compared outcomes between 82 children who completed an IPE program and 102 who did not.
- Used logistic regression to analyze the relationship between multiple release surgeries and IPE participation.
Main Results:
- Patients in both groups had similar injury severity.
- Intensive physical exercise (IPE) patients underwent 120 releases, while non-IPE patients required 211 releases.
- A ~60% reduction in repeat release surgeries was observed in the IPE group (12.5% vs. 31.8%, P < 0.05).
Conclusions:
- Intensive physical exercise (IPE) may be a beneficial adjunct therapy for reducing contracture release procedures in pediatric burn survivors.
- Further research is needed to elucidate the mechanisms behind the positive effects of exercise in burn rehabilitation.
Background:
Intensive physical exercise (IPE) increases strength, lean body mass, aerobic capacity, and range of motion in children with extensive burns. However, whether IPE decreases the frequency of burn scar contracture-releasing procedures in children with extensive burns is unknown.
Materials And Methods:
Prospectively collected surgical records of 184 children who had undergone axilla, elbow, and/or wrist contracture-releasing procedures were reviewed. All children were 7 years or older and had sustained burns of at least 40% of the total body surface area. Eighty-two children completed an IPE program, and 102 children did not. For both groups, the axilla, elbow, and wrist were examined for tightness and restricted movement. Children with contractural difficulty were prescribed a releasing procedure. Logistic regression was used to model the relationship between multiple release surgeries and group.
Results:
Patients in both groups had comparable injury severity. A total of 120 releases were carried out in the 82 IPE patients. In contrast, 211 releases were needed in the 102 non-IPE patients. An approximately 60% decrease in the frequency of rerelease operations was noted in IPE patients (12.5% for the IPE group and 31.8% for non-IPE group; P < 0.05).
Conclusions:
When used as an adjunct therapy in postburn rehabilitation, IPE may be useful for reducing the need for contracture release. The mechanisms underlying the beneficial effects of exercise remain undefined and should be investigated.
