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Effects of Aerobic Exercise in the Intensive Care Unit on Patient-Reported Physical Function and Mental Health
Alen Palackic1,2, Andrea Rego1, Ingrid Parry3
1Department of Surgery, School of Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA.
Insights
This study found that while exercise improved outcomes for pediatric burn patients, adding extra exercise to standard care did not show additional benefits. Further research is recommended to explore supervised exercise for burn survivors.
Area of Science:
- Pediatric critical care
- Burn rehabilitation
- Exercise physiology
Background:
- Severe burns significantly impact children's physical and mental health during critical developmental stages.
- While exercise benefits the general population, its effect on pediatric burn patients' quality of life needs further investigation.
Purpose of the Study:
- To evaluate the impact of additional exercise on the quality of life for pediatric burn patients.
Main Methods:
- Forty-eight pediatric patients (7-17 years) with ≥30% total body surface area (TBSA) burns were randomized to standard-of-care (SOC) or SOC plus exercise (SOC+Ex).
- Patient-reported physical and mental health outcomes were collected via surveys at admission and discharge.
- Statistical significance was determined at p < 0.05.
Main Results:
- Both SOC and SOC+Ex groups showed significant improvements in physical and mental health outcomes during hospitalization (p < 0.05).
- The SOC+Ex group received an average of 10 exercise sessions with a 25% attendance rate.
- No additional benefits were observed in the SOC+Ex group compared to the SOC group for the measured outcomes.
Conclusions:
- Pediatric burn patients in the Burn Intensive Care Unit (BICU) should continue with SOC, with physician consultation regarding additional aerobic exercise.
- Aerobic exercise, when properly supervised, was not found to be harmful to pediatric burn survivors.
- Further research may explore optimal exercise regimens for pediatric burn survivors beyond standard care.
Abstract:
Severe burns are life-altering and can have lasting effects on patients' physical and mental health. Alterations in physical function, changes in appearance, and psychological disturbances resulting from severe burns are especially concerning in children, as they are still in the early stages of identity formation. Exercise in the nonburn population has been shown to improve quality of life and result in better physical and mental status. However, the effect of early exercise on the quality of life in pediatric burn patients requires more research.
Methods:
Forty-eight children between the ages of seven and seventeen with ≥30% total body surface area (TBSA) burn were randomized in a 1:2 fashion to receive treatment with standard-of-care (SOC) or standard-of-care plus exercise (SOC+Ex). Surveys administered at admission and discharge collected patient-reported information regarding physical and mental health outcomes. The results are given as means +/- standard deviation. Significance was set at p < 0.05.
Results:
The average age of the SOC and SOC+Ex groups were 12 ± 3 and 13 ± 4 years, respectively. The average %TBSA burned in the SOC and SOC+Ex groups were 54 ± 17 and 48 ± 14, respectively. The SOC+Ex group averaged 10 ± 9 exercise sessions (range of 1 to 38 sessions) with an attendance rate of 25% (10 sessions out of 40 BICU days). Both groups demonstrated significant improvement in patient-reported physical and mental outcomes during hospital admission (p < 0.05) However, additional exercise did not exhibit any additional benefits for measured levels.
Conclusions:
Our recommendation is for all pediatric patients in the BICU to continue with the SOC and consult with their physician over the benefits of additional aerobic exercise. This study suggests that perhaps there is potential for increasing the amount of exercise that can be administered to pediatric burn survivors beyond SOC as we did not find aerobic exercise to be of any harm to any patients if it is performed properly and under supervision.
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