Effects of different duration exercise programs in children with severe burns.

Introduction: Burns lead to persistent and detrimental muscle breakdown and weakness. Standard treatment at our institution includes a voluntary 12-week rehabilitative exercise program to limit and reverse the effects of increased muscle catabolism. In the present work, we investigated if different durations of exercise, 6 or 12 weeks, produce comparable improvements in muscle strength, body composition, and cardiopulmonary fitness.

Methods: We prospectively enrolled and randomized patients with ≥30% total body surface area (TBSA) burned to receive 6 or 12 weeks of exercise rehabilitation. Patients were evaluated for muscle strength, oxygen consumption capacity, and lean body mass at discharge (n=42) and after exercise. After 6 weeks (n=18) or 12 weeks (n=24) of exercise training, leg muscle strength was assessed as peak torque per body weight using a Biodex isokinetic dynamometer. Oxygen consumption capacity, measured as peak VO, was studied using a standard treadmill-based test, and lean body mass was determined using dual-energy X-ray absorptiometry.

Results: Significant improvements in muscle strength, peak VO, and lean body mass were seen after 6 weeks of exercise training (p<0.001), with only significant improvements in peak VO being seen after 6 weeks more of training.

Conclusion: These data suggest that a 6-week rehabilitative exercise program is sufficient for improving muscle strength, body composition, and cardiopulmonary fitness in pediatric burn patients. However, continuation of at- or near-home cardiopulmonary training following the 6 weeks of at-hospital rehabilitation may be useful.