Cardiorespiratory Capacity and Strength Remain Attenuated in Children with Severe Burn Injuries at Over 3 Years Postburn

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d654508e199">Objectives</h5> <p id="P1">To compare physical capacity and body composition between burned children at approximately 4 years postburn and healthy fit children. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d654508e204">Study design</h5> <p id="P2">In this retrospective case-control study, we analyzed strength, aerobic capacity, and body composition of severely burned children (n=40) at discharge, after completion of a 6 to 12-week rehabilitative exercise training program, and at 3 to 4 years postburn. Values were expressed as a relative percentage of those in sex/age-matched children for comparison (n=40 for discharge and post exercise; n=40 for 3.5 years postburn). </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d654508e209">Results</h5> <p id="P3">At discharge, lean body mass (LBM) was 89% of that in non-burned children, and exercise rehabilitation restored this to 94% ( <i>P</i> &lt; .01). At 3.5 years postburn, LBM (94%), bone mineral content (89%), and bone mineral density (93%; each p≤0.02) remained reduced, while total body fat was increased (148%, p=0.01). Cardiorespiratory fitness remained lower in burned children both after exercise training (75%; p&lt;0.0001) and 3.5 years later (87%; p&lt;0.001). Peak torque (60%; p&lt;0.0001) and average power output (58%; p&lt;0.0001) were lower after discharge. Although exercise training improved these, they failed to reach non-burned levels (83–84%; p&lt;0.0001) but were maintained at 85% and 82%, respectively, 3.5 years later (p&lt;0.0001). </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d654508e217">Conclusions</h5> <p id="P4">Although the benefits of rehabilitative exercise training on strength and cardiorespiratory capacity are maintained at almost 4 years postburn, they are not fully restored to the levels of healthy children. Although the underlying mechanism of this phenomenon remains elusive, these findings suggest that future development of continuous exercise rehabilitation interventions after discharge may further narrow the gap in relation to healthy adolescents. </p> </div>