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

Janos Cambiaso-Daniel, Eric Rivas, Joshua S. Carson, Gabriel Hundeshagen, Omar Nunez Lopez, Shauna Q. Glover, David Herndon, Oscar Suman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives To compare physical capacity and body composition between children with burn injuries at approximately 4 years postburn and healthy, fit children. Study design In this retrospective, case-control study, we analyzed the strength, aerobic capacity, and body composition of children with severe burn injuries (n = 40) at discharge, after completion of a 6- to 12-week rehabilitative exercise training program, and at 3-4 years postburn. Values were expressed as a relative percentage of those in age- and sex-matched children for comparison (n = 40 for discharge and postexercise; n = 40 for 3.5 years postburn). Results At discharge, lean body mass was 89% of that in children without burn injuries, and exercise rehabilitation restored this to 94% (P <.01). At 3.5 years postburn, lean body mass (94%), bone mineral content (89%), and bone mineral density (93%; each P ≤.02) remained reduced, whereas total body fat was increased (148%, P =.01). Cardiorespiratory fitness remained lower in children with burn injuries both after exercise training (75%; P <.0001) and 3.5 years later (87%; P <.001). Peak torque (60%; P <.0001) and average power output (58%; P <.0001) were lower after discharge. Although exercise training improved these, they failed to reach levels achieved in healthy children without burns (83-84%; P <.0001) but were maintained at 85% and 82%, respectively, 3.5 years later (P <.0001). Conclusions Although the benefits of rehabilitative exercise training on strength and cardiorespiratory capacity are maintained at almost 4 years postburn, they are not restored fully 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.

Original languageEnglish (US)
Pages (from-to)152-158
Number of pages7
JournalJournal of Pediatrics
Volume192
DOIs
StatePublished - Jan 1 2018

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Wounds and Injuries
Exercise
Exercise Therapy
Body Composition
Bone Density
Torque
Burns
Adipose Tissue
Case-Control Studies
Education

Keywords

  • body composition
  • exercise program
  • muscle strength
  • peak aerobic capacity
  • rehabilitation
  • standard of care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Cardiorespiratory Capacity and Strength Remain Attenuated in Children with Severe Burn Injuries at Over 3 Years Postburn. / Cambiaso-Daniel, Janos; Rivas, Eric; Carson, Joshua S.; Hundeshagen, Gabriel; Lopez, Omar Nunez; Glover, Shauna Q.; Herndon, David; Suman, Oscar.

In: Journal of Pediatrics, Vol. 192, 01.01.2018, p. 152-158.

Research output: Contribution to journalArticle

Cambiaso-Daniel, Janos ; Rivas, Eric ; Carson, Joshua S. ; Hundeshagen, Gabriel ; Lopez, Omar Nunez ; Glover, Shauna Q. ; Herndon, David ; Suman, Oscar. / Cardiorespiratory Capacity and Strength Remain Attenuated in Children with Severe Burn Injuries at Over 3 Years Postburn. In: Journal of Pediatrics. 2018 ; Vol. 192. pp. 152-158.
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title = "Cardiorespiratory Capacity and Strength Remain Attenuated in Children with Severe Burn Injuries at Over 3 Years Postburn",
abstract = "Objectives To compare physical capacity and body composition between children with burn injuries at approximately 4 years postburn and healthy, fit children. Study design In this retrospective, case-control study, we analyzed the strength, aerobic capacity, and body composition of children with severe burn injuries (n = 40) at discharge, after completion of a 6- to 12-week rehabilitative exercise training program, and at 3-4 years postburn. Values were expressed as a relative percentage of those in age- and sex-matched children for comparison (n = 40 for discharge and postexercise; n = 40 for 3.5 years postburn). Results At discharge, lean body mass was 89{\%} of that in children without burn injuries, and exercise rehabilitation restored this to 94{\%} (P <.01). At 3.5 years postburn, lean body mass (94{\%}), bone mineral content (89{\%}), and bone mineral density (93{\%}; each P ≤.02) remained reduced, whereas total body fat was increased (148{\%}, P =.01). Cardiorespiratory fitness remained lower in children with burn injuries both after exercise training (75{\%}; P <.0001) and 3.5 years later (87{\%}; P <.001). Peak torque (60{\%}; P <.0001) and average power output (58{\%}; P <.0001) were lower after discharge. Although exercise training improved these, they failed to reach levels achieved in healthy children without burns (83-84{\%}; P <.0001) but were maintained at 85{\%} and 82{\%}, respectively, 3.5 years later (P <.0001). Conclusions Although the benefits of rehabilitative exercise training on strength and cardiorespiratory capacity are maintained at almost 4 years postburn, they are not restored fully 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.",
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T1 - Cardiorespiratory Capacity and Strength Remain Attenuated in Children with Severe Burn Injuries at Over 3 Years Postburn

AU - Cambiaso-Daniel, Janos

AU - Rivas, Eric

AU - Carson, Joshua S.

AU - Hundeshagen, Gabriel

AU - Lopez, Omar Nunez

AU - Glover, Shauna Q.

AU - Herndon, David

AU - Suman, Oscar

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N2 - Objectives To compare physical capacity and body composition between children with burn injuries at approximately 4 years postburn and healthy, fit children. Study design In this retrospective, case-control study, we analyzed the strength, aerobic capacity, and body composition of children with severe burn injuries (n = 40) at discharge, after completion of a 6- to 12-week rehabilitative exercise training program, and at 3-4 years postburn. Values were expressed as a relative percentage of those in age- and sex-matched children for comparison (n = 40 for discharge and postexercise; n = 40 for 3.5 years postburn). Results At discharge, lean body mass was 89% of that in children without burn injuries, and exercise rehabilitation restored this to 94% (P <.01). At 3.5 years postburn, lean body mass (94%), bone mineral content (89%), and bone mineral density (93%; each P ≤.02) remained reduced, whereas total body fat was increased (148%, P =.01). Cardiorespiratory fitness remained lower in children with burn injuries both after exercise training (75%; P <.0001) and 3.5 years later (87%; P <.001). Peak torque (60%; P <.0001) and average power output (58%; P <.0001) were lower after discharge. Although exercise training improved these, they failed to reach levels achieved in healthy children without burns (83-84%; P <.0001) but were maintained at 85% and 82%, respectively, 3.5 years later (P <.0001). Conclusions Although the benefits of rehabilitative exercise training on strength and cardiorespiratory capacity are maintained at almost 4 years postburn, they are not restored fully 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.

AB - Objectives To compare physical capacity and body composition between children with burn injuries at approximately 4 years postburn and healthy, fit children. Study design In this retrospective, case-control study, we analyzed the strength, aerobic capacity, and body composition of children with severe burn injuries (n = 40) at discharge, after completion of a 6- to 12-week rehabilitative exercise training program, and at 3-4 years postburn. Values were expressed as a relative percentage of those in age- and sex-matched children for comparison (n = 40 for discharge and postexercise; n = 40 for 3.5 years postburn). Results At discharge, lean body mass was 89% of that in children without burn injuries, and exercise rehabilitation restored this to 94% (P <.01). At 3.5 years postburn, lean body mass (94%), bone mineral content (89%), and bone mineral density (93%; each P ≤.02) remained reduced, whereas total body fat was increased (148%, P =.01). Cardiorespiratory fitness remained lower in children with burn injuries both after exercise training (75%; P <.0001) and 3.5 years later (87%; P <.001). Peak torque (60%; P <.0001) and average power output (58%; P <.0001) were lower after discharge. Although exercise training improved these, they failed to reach levels achieved in healthy children without burns (83-84%; P <.0001) but were maintained at 85% and 82%, respectively, 3.5 years later (P <.0001). Conclusions Although the benefits of rehabilitative exercise training on strength and cardiorespiratory capacity are maintained at almost 4 years postburn, they are not restored fully 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.

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KW - muscle strength

KW - peak aerobic capacity

KW - rehabilitation

KW - standard of care

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