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严重热烧伤成年患者的下肢肌肉力量、平衡能力和活动水平

Lower-Limb Muscular Strength, Balance, and Mobility Levels in Adults Following Severe Thermal Burn Injuries.

作者信息

Omar Mohammed T A, Abd El Baky Amal M, Ebid Anwar A

机构信息

From the *Physical Therapy Department for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt; and †Collage of Applied Medical Science (CAMS) - Majmaah University, Al Majmaah, Kingdom of Saudi Arabia.

出版信息

J Burn Care Res. 2017 Sep/Oct;38(5):327-333. doi: 10.1097/BCR.0000000000000495.

Abstract

Severe burn injuries are associated with hypermetabolic response and increased catabolism. These lead to a vast loss of muscle mass and reduced muscle strength and function. Therefore, the aim of this study is to determine the impact of severe burn injuries on lower-limb muscular strength, balance, and mobility level in adults. Forty burned adults with burned TBSA (burned TBSA) ≥40% participated in this study. The peak torque and total work of quadriceps and knee flexors were calculated at 150°/sec using Biodex isokinetic dynamometer. Balance and mobility were tested via the Biodex balance device and the high mobility assessment tool, respectively. Twenty-three matched nonburned healthy adults were evaluated and served as a control group. Severely burned adults exhibited significantly lower peak torque and total work in their quadriceps (27.50 and 22.58%, P < .05) and knee flexors (23.72, and 21.65%, P < .05) relative to the nonburned adults. Burned adults had a significant decrease in stability index and balance including the dynamic limits of stability (P < .05). The high mobility assessment tool scores were significantly lower (42 ± 7.64, P < .05) when compared with control subjects (51 ± 1.62). Patients who had severe burns (burned TBSA ≥ 40%) showed muscular weakness, limited balance, and mobility levels between 16 and 24 weeks after discharge from the hospital compared with matched nonburned control subjects. These results can guide therapists in creating rehabilitation programs that focus on the specific difficulties faced by burned patients.

摘要

严重烧伤与高代谢反应和分解代谢增加有关。这些会导致肌肉大量流失,肌肉力量和功能下降。因此,本研究的目的是确定严重烧伤对成年人下肢肌肉力量、平衡和活动能力的影响。40名烧伤总面积(TBSA)≥40%的成年烧伤患者参与了本研究。使用Biodex等速测力计在150°/秒时计算股四头肌和膝屈肌的峰值扭矩和总功。分别通过Biodex平衡装置和高活动能力评估工具测试平衡和活动能力。评估了23名匹配的未烧伤健康成年人作为对照组。与未烧伤的成年人相比,严重烧伤的成年人股四头肌(分别降低27.50%和22.58%,P < .05)和膝屈肌(分别降低23.72%和21.65%,P < .05)的峰值扭矩和总功显著降低。烧伤成年人的稳定性指数和平衡显著下降,包括动态稳定极限(P < .05)。与对照组受试者(51±1.62)相比,高活动能力评估工具得分显著更低(42±7.64,P < .05)。与匹配的未烧伤对照组受试者相比,严重烧伤(TBSA≥40%)的患者在出院后16至24周表现出肌肉无力、平衡受限和活动能力下降。这些结果可以指导治疗师制定针对烧伤患者所面临特定困难的康复计划。

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