Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation

Ahmed M. Al-Mousawi, Felicia N. Williams, Ronald P. Mlcak, Marc G. Jeschke, David Herndon, Oscar Suman

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Severe burns cause profound hormonal and metabolic disturbances resulting in hypermetabolism, reflected in extreme elevation of resting energy expenditure (REE) and extensive skeletal muscle catabolism. Aerobic and resistive exercise programs during rehabilitation have shown substantial benefits, although whether such training potentially exacerbates basal metabolism is unknown. Therefore, the effects of exercise training on REE during the rehabilitation of severely burned pediatric patients were examined. Children with 40% total body surface area burns and greater were enrolled at admission to the burn intensive care unit to participate in a 12-week, hospital-based exercise program (EX) or a home-based standard of care program (SOC), commencing 6 months after injury. Twenty-one patients (aged 7-17 years) were enrolled and randomized to SOC (n = 10) or EX (n = 11). Age, sex, and total body surface area burned were similar. Mean change (±standard deviation) in REE, normalized to individual lean body mass, was almost negligible between SOC and EX group patients (SOC, 0.03 ± 17.40% vs EX, 0.01 ± 26.38%). A significant increase in lean body mass was found for EX patients (SOC, 2.06 ± 3.17% vs EX, 8.75 ± 5.65%; P = .004), which persisted when normalized to height (SOC, 0.70 ± 2.39% vs EX, 6.14 ± 6.46%; P = .02). Peak torque also improved significantly more in EX patients (SOC, 12.29 ± 16.49% vs EX, 54.31 ± 44.25%; P = .02), reflecting improved strength. Exercise training significantly enhanced lean mass and strength, without observed exacerbation of postburn hypermetabolism. Therefore, the use of exercise conditioning as a safe and effective component of pediatric burn rehabilitation is advocated.

Original languageEnglish (US)
Pages (from-to)400-408
Number of pages9
JournalJournal of Burn Care and Research
Volume31
Issue number3
DOIs
StatePublished - May 2010

Fingerprint

Standard of Care
Energy Metabolism
Rehabilitation
Exercise
Pediatrics
Patient Care
Body Surface Area
Burns
Basal Metabolism
Torque
Intensive Care Units
Skeletal Muscle
Wounds and Injuries

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery

Cite this

Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation. / Al-Mousawi, Ahmed M.; Williams, Felicia N.; Mlcak, Ronald P.; Jeschke, Marc G.; Herndon, David; Suman, Oscar.

In: Journal of Burn Care and Research, Vol. 31, No. 3, 05.2010, p. 400-408.

Research output: Contribution to journalArticle

Al-Mousawi, Ahmed M. ; Williams, Felicia N. ; Mlcak, Ronald P. ; Jeschke, Marc G. ; Herndon, David ; Suman, Oscar. / Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation. In: Journal of Burn Care and Research. 2010 ; Vol. 31, No. 3. pp. 400-408.
@article{f20cc698f8264dfdaf92363aca3a46a8,
title = "Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation",
abstract = "Severe burns cause profound hormonal and metabolic disturbances resulting in hypermetabolism, reflected in extreme elevation of resting energy expenditure (REE) and extensive skeletal muscle catabolism. Aerobic and resistive exercise programs during rehabilitation have shown substantial benefits, although whether such training potentially exacerbates basal metabolism is unknown. Therefore, the effects of exercise training on REE during the rehabilitation of severely burned pediatric patients were examined. Children with 40{\%} total body surface area burns and greater were enrolled at admission to the burn intensive care unit to participate in a 12-week, hospital-based exercise program (EX) or a home-based standard of care program (SOC), commencing 6 months after injury. Twenty-one patients (aged 7-17 years) were enrolled and randomized to SOC (n = 10) or EX (n = 11). Age, sex, and total body surface area burned were similar. Mean change (±standard deviation) in REE, normalized to individual lean body mass, was almost negligible between SOC and EX group patients (SOC, 0.03 ± 17.40{\%} vs EX, 0.01 ± 26.38{\%}). A significant increase in lean body mass was found for EX patients (SOC, 2.06 ± 3.17{\%} vs EX, 8.75 ± 5.65{\%}; P = .004), which persisted when normalized to height (SOC, 0.70 ± 2.39{\%} vs EX, 6.14 ± 6.46{\%}; P = .02). Peak torque also improved significantly more in EX patients (SOC, 12.29 ± 16.49{\%} vs EX, 54.31 ± 44.25{\%}; P = .02), reflecting improved strength. Exercise training significantly enhanced lean mass and strength, without observed exacerbation of postburn hypermetabolism. Therefore, the use of exercise conditioning as a safe and effective component of pediatric burn rehabilitation is advocated.",
author = "Al-Mousawi, {Ahmed M.} and Williams, {Felicia N.} and Mlcak, {Ronald P.} and Jeschke, {Marc G.} and David Herndon and Oscar Suman",
year = "2010",
month = "5",
doi = "10.1097/BCR.0b013e3181db5317",
language = "English (US)",
volume = "31",
pages = "400--408",
journal = "Journal of Burn Care and Research",
issn = "1559-047X",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation

AU - Al-Mousawi, Ahmed M.

AU - Williams, Felicia N.

AU - Mlcak, Ronald P.

AU - Jeschke, Marc G.

AU - Herndon, David

AU - Suman, Oscar

PY - 2010/5

Y1 - 2010/5

N2 - Severe burns cause profound hormonal and metabolic disturbances resulting in hypermetabolism, reflected in extreme elevation of resting energy expenditure (REE) and extensive skeletal muscle catabolism. Aerobic and resistive exercise programs during rehabilitation have shown substantial benefits, although whether such training potentially exacerbates basal metabolism is unknown. Therefore, the effects of exercise training on REE during the rehabilitation of severely burned pediatric patients were examined. Children with 40% total body surface area burns and greater were enrolled at admission to the burn intensive care unit to participate in a 12-week, hospital-based exercise program (EX) or a home-based standard of care program (SOC), commencing 6 months after injury. Twenty-one patients (aged 7-17 years) were enrolled and randomized to SOC (n = 10) or EX (n = 11). Age, sex, and total body surface area burned were similar. Mean change (±standard deviation) in REE, normalized to individual lean body mass, was almost negligible between SOC and EX group patients (SOC, 0.03 ± 17.40% vs EX, 0.01 ± 26.38%). A significant increase in lean body mass was found for EX patients (SOC, 2.06 ± 3.17% vs EX, 8.75 ± 5.65%; P = .004), which persisted when normalized to height (SOC, 0.70 ± 2.39% vs EX, 6.14 ± 6.46%; P = .02). Peak torque also improved significantly more in EX patients (SOC, 12.29 ± 16.49% vs EX, 54.31 ± 44.25%; P = .02), reflecting improved strength. Exercise training significantly enhanced lean mass and strength, without observed exacerbation of postburn hypermetabolism. Therefore, the use of exercise conditioning as a safe and effective component of pediatric burn rehabilitation is advocated.

AB - Severe burns cause profound hormonal and metabolic disturbances resulting in hypermetabolism, reflected in extreme elevation of resting energy expenditure (REE) and extensive skeletal muscle catabolism. Aerobic and resistive exercise programs during rehabilitation have shown substantial benefits, although whether such training potentially exacerbates basal metabolism is unknown. Therefore, the effects of exercise training on REE during the rehabilitation of severely burned pediatric patients were examined. Children with 40% total body surface area burns and greater were enrolled at admission to the burn intensive care unit to participate in a 12-week, hospital-based exercise program (EX) or a home-based standard of care program (SOC), commencing 6 months after injury. Twenty-one patients (aged 7-17 years) were enrolled and randomized to SOC (n = 10) or EX (n = 11). Age, sex, and total body surface area burned were similar. Mean change (±standard deviation) in REE, normalized to individual lean body mass, was almost negligible between SOC and EX group patients (SOC, 0.03 ± 17.40% vs EX, 0.01 ± 26.38%). A significant increase in lean body mass was found for EX patients (SOC, 2.06 ± 3.17% vs EX, 8.75 ± 5.65%; P = .004), which persisted when normalized to height (SOC, 0.70 ± 2.39% vs EX, 6.14 ± 6.46%; P = .02). Peak torque also improved significantly more in EX patients (SOC, 12.29 ± 16.49% vs EX, 54.31 ± 44.25%; P = .02), reflecting improved strength. Exercise training significantly enhanced lean mass and strength, without observed exacerbation of postburn hypermetabolism. Therefore, the use of exercise conditioning as a safe and effective component of pediatric burn rehabilitation is advocated.

UR - http://www.scopus.com/inward/record.url?scp=77952311222&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952311222&partnerID=8YFLogxK

U2 - 10.1097/BCR.0b013e3181db5317

DO - 10.1097/BCR.0b013e3181db5317

M3 - Article

C2 - 20354445

AN - SCOPUS:77952311222

VL - 31

SP - 400

EP - 408

JO - Journal of Burn Care and Research

JF - Journal of Burn Care and Research

SN - 1559-047X

IS - 3

ER -