title: Aerobic Fitness Is Disproportionately Low in Adult Burn Survivors Years After Injury.
abstract: A maximal aerobic capacity below the 20th percentile is associated with an increased risk of all-cause mortality (Blair 1995). Adult Adult burn survivors have a lower aerobic capacity compared with nonburned adults when evaluated 38 ± 23 days postinjury (deLateur 2007). However, it is unknown whether burn survivors with well-healed skin grafts (ie, multiple years postinjury) also have low aerobic capacity. This project tested the hypothesis that aerobic fitness, as measured by maximal aerobic capacity (VO2max), is reduced in well-healed adult burn survivors when compared with normative values from nonburned individuals. Twenty-five burn survivors (36 ± 12 years old; 13 females) with well-healed split-thickness grafts (median, 16 years postinjury; range, 1-51 years) covering at least 17% of their BSA (mean, 40 ± 16%; range, 17-75%) performed a graded cycle ergometry exercise to test volitional fatigue. Expired gases and minute ventilation were measured via a metabolic cart for the determination of VO2max. Each subject's VO2max was compared with sex- and age-matched normative values from population data published by the American College of Sports Medicine, the American Heart Association, and recent epidemiological data (Aspenes 2011). Subjects had a VO2max of 29.4 ± 10.1 ml O2/kg body mass/min (median, 27.5; range, 15.9-53.3). The use of American College of Sports Medicine normative values showed that mean VO2max of the subjects was in the lower 24th percentile (median, 10th percentile). A total of 88% of the subjects had a VO2max below American Heart Association age-adjusted normative values. Similarly, 20 of the 25 subjects had a VO2max in the lower 25% percentile of recent epidemiological data. Relative to nongrafted subjects, 80 to 88% of the evaluated skin-graft subjects had a very low aerobic capacity. On the basis of these findings, adult burn survivors are disproportionally unfit relative to the general U.S. population, and this puts them at an increased risk of all-cause mortality (Blair 1995).
authors.affiliation: From the *University of Texas Southwestern Medical Center at Dallas and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas; †Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR; ‡School of Health Sciences, Cardiff Metropolitan University, United Kingdom; §Department of Kinesiology and Health Education, University of Texas, Austin; and ‖Centre for Global Health Research, Umea University, Sweden.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Ganio
authors.forename: James
authors.initials: J
authors.lastname: Pearson
authors.forename: Zachary J
authors.initials: ZJ
authors.lastname: Schlader
authors.forename: Robert Matthew
authors.initials: RM
authors.lastname: Brothers
authors.forename: Rebekah A I
authors.initials: RA
authors.lastname: Lucas
authors.forename: Eric
authors.initials: E
authors.lastname: Rivas
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Kowalske
authors.forename: Craig G
authors.initials: CG
authors.lastname: Crandall
mesh_terms: D000328:Adult; D002056:Burns / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D016555:Matched-Pair Analysis; D010101:Oxygen Consumption / Q000502:physiology*; D010809:Physical Fitness / Q000502:physiology*; D017741:Survivors
chemical_list: D019344:Lactic Acid
references.citation: JAMA. 1995 Apr 12;273(14):1093-8
references.pmid: 7707596
references.citation: J Appl Physiol Respir Environ Exerc Physiol. 1982 Oct;53(4):1019-22
references.pmid: 7153111
references.citation: J Appl Physiol (1985). 2001 Sep;91(3):1168-75
references.pmid: 11509512
references.citation: Ann Surg. 1980;192(4):472-8
references.pmid: 7425694
references.citation: Circ Shock. 1981;8(1):105-15
references.pmid: 7016359
references.citation: Am J Surg. 1959 Nov;98:693-4
references.pmid: 14440877
references.citation: J Burn Care Rehabil. 2002 Jul-Aug;23(4):288-93; discussion 287
references.pmid: 12142585
references.citation: J Burn Care Res. 2010 Jul-Aug;31(4):631-9
references.pmid: 20523226
references.citation: Burns. 2008 Jun;34(4):433-40
references.pmid: 18207643
references.citation: Circulation. 2001 Oct 2;104(14):1694-740
references.pmid: 11581152
references.citation: Burns. 2012 Jun;38(4):607-13
references.pmid: 22342175
references.citation: Med Sci Sports Exerc. 1995 Sep;27(9):1292-301
references.pmid: 8531628
references.citation: J Trauma. 1994 Aug;37(2):167-70
references.pmid: 8064909
references.citation: Ann Surg. 2000 Oct;232(4):455-65
references.pmid: 10998644
references.citation: Eur Respir J. 2012 Jul;40(1):190-7
references.pmid: 22183491
references.citation: Plast Reconstr Surg. 1981 Apr;67(4):499-504
references.pmid: 7208693
references.citation: J Burn Care Res. 2007 Jul-Aug;28(4):611-4
references.pmid: 17514029
references.citation: Burns. 2011 Dec;37(8):1326-33
references.pmid: 21530086
references.citation: Circulation. 1982 Jan;65(1):134-40
references.pmid: 6796287
references.citation: JAMA. 1989 Nov 3;262(17):2395-401
references.pmid: 2795824
references.citation: Scand J Rehabil Med. 1970;2(2):92-8
references.pmid: 5523831
references.citation: Burns. 2006 Feb;32(1):1-9
references.pmid: 16376020
references.citation: Eur Respir J. 2012 Dec;40(6):1324-43
references.pmid: 22743675
references.citation: Arch Phys Med Rehabil. 2007 Dec;88(12 Suppl 2):S57-64
references.pmid: 18036983
references.citation: Arch Phys Med Rehabil. 2007 Dec;88(12 Suppl 2):S18-23
references.pmid: 18036976
references.citation: Can Respir J. 2013 Jan-Feb;20(1):13-21
references.pmid: 23457669
references.citation: Ann Plast Surg. 1978 Mar;1(2):172-6
references.pmid: 365049
references.citation: J Burn Care Res. 2011 Jan-Feb;32(1):66-78
references.pmid: 21124232
references.citation: Med Sci Sports Exerc. 2011 Aug;43(8):1465-73
references.pmid: 21228724
references.citation: J Appl Physiol. 1973 Nov;35(5):649-54
references.pmid: 4770349
references.citation: J Rehabil Med. 2007 Jan;39(1):49-55
references.pmid: 17225038