title: Effects of different duration exercise programs in children with severe burns.
abstract: BACKGROUND
  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 VO2, 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 VO2, and lean body mass were seen after 6 weeks of exercise training (p<0.001), with only significant improvements in peak VO2being seen after 6 weeks more of training.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; The Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: rpclayto@utmb.edu.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Clayton
authors.affiliation: Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Paul
authors.initials: P
authors.lastname: Wurzer
authors.affiliation: Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Clark R
authors.initials: CR
authors.lastname: Andersen
authors.affiliation: Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Mlcak
authors.affiliation: Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; The Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.affiliation: Shriners Hospitals for Children(®)-Galveston, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: oesuman@utmb.edu.
authors.forename: Oscar E
authors.initials: OE
authors.lastname: Suman
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D002056:Burns / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation*; D000072599:Cardiorespiratory Fitness; D002648:Child; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D010101:Oxygen Consumption; D013997:Time Factors; D015599:Trauma Severity Indices
keywords: Burns; Children; Rehabilitation; Resistance exercise