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Rehabilitation Exercise Increases Physical Activity Levels in Severely Burned Children While Improving Aerobic
Eric Rivas1,2,3, Joan Tran1,2, Ileana L Gutierrez1
1Shriners Hospitals for Children, Galveston, TX.
Insights
Burned children in rehabilitation programs showed similar daily steps to healthy peers. However, their overall daily activity minutes were lower, indicating potential for further improvement in physical activity levels.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Sports Medicine
Background:
- Severely burned children often experience reduced physical activity post-hospitalization.
- Assessing physical activity levels in burned children compared to healthy peers is crucial for recovery.
Purpose of the Study:
- To test if rehabilitation exercise increases physical activity in burned children compared to free-living nonburned children.
- To evaluate the impact of exercise on strength and cardiorespiratory fitness in burned children.
Main Methods:
- Thirty-one burned children and 31 matched nonburned children were monitored using pedometers.
- Physical activity (steps, minutes) was recorded during rehabilitation and free-living conditions.
- Peak torque, mean power, and cardiorespiratory fitness were measured before and after exercise training.
Main Results:
- Burned children had lower average daily activity minutes (56 vs. 74) but similar daily steps compared to nonburned children.
- Exercise training significantly improved strength (peak torque, mean power) and cardiorespiratory fitness in burned children.
- Greater burn severity (percentage TBSA) was inversely associated with physical activity levels.
Conclusions:
- Burned children can achieve comparable daily step counts to healthy peers upon discharge.
- Rehabilitation exercise programs effectively enhance strength and fitness in burned children.
- Physical activity monitoring can aid in optimizing exercise capacity for burned children in free-living settings.
Abstract:
This study tested the hypothesis that participation in a rehabilitation exercise program following hospital discharge would increase the level of physical activity in burned children than that seen in free-living nonburned children. Thirty-one severely burned children (12 ± 3 years, 144 ± 18 cm, 42 ± 17 kg, 48 ± 12% TBSA burns) were matched to 31 nonburned children (12 ± 3 y, 147 ± 17 cm, 45 ± 15 kg) based on age and sex. Pedometers were used to track minutes and steps in burned children during their exercise rehabilitation and nonburned children under free-living conditions (healthy control). We found that the average minutes of activity per day was lower in burned children (56 ± 25minutes) than in nonburned children (74 ± 28 minutes, P < .05). However, no difference was detected for average steps per day or week or maximal minutes in 1 day or week. At discharge, burn children had peak torque and mean power values that were 61% of nonburned values, and exercise training improved these by 27 and 28%, respectively (88 and 89% of nonburned values; each P ≤ .0001). Likewise, cardiorespiratory fitness at discharge was 72% of nonburned values, and exercise training improved fitness by 10% (82% of nonburned values, P < .05). Percentage TBSA burned was inversely associated with steps (r = -0.54, P = .001) and minutes of activity (r = -0.53, P = .002), accounting for 28-29% of the variability in burned children. These results show that, at discharge, burned children are capable of matching steps of physical activity levels seen in nonburned healthy children. Physical activity monitoring may be a viable option for continued improvement of physical exercise capacity when burned children are under free-living conditions.
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