Cambiaso-Daniel Janos, Rivas Eric, Carson Joshua S, Hundeshagen Gabriel, Nunez Lopez Omar, Glover Shauna Q, Herndon David N, Suman Oscar E
Department of Surgery, University of Texas Medical Branch, Galveston, TX; Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
Department of Surgery, University of Texas Medical Branch, Galveston, TX; Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX; Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX.
J Pediatr. 2018 Jan;192:152-158. doi: 10.1016/j.jpeds.2017.09.015.
To compare physical capacity and body composition between children with burn injuries at approximately 4 years postburn and healthy, fit children.
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).
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).
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.
比较烧伤儿童在烧伤后约4年时与健康、体能良好儿童之间的身体能力和身体成分。
在这项回顾性病例对照研究中，我们分析了重度烧伤儿童（n = 40）在出院时、完成6至12周康复运动训练计划后以及烧伤后3至4年时的力量、有氧能力和身体成分。数值以年龄和性别匹配儿童的相对百分比表示，以便进行比较（出院时和运动后为n = 40；烧伤后3.5年为n = 40）。
出院时，瘦体重为未烧伤儿童的89%，运动康复后恢复至94%（P <.01）。烧伤后3.5年，瘦体重（94%）、骨矿物质含量（89%）和骨矿物质密度（93%；各P≤.02）仍降低，而全身脂肪增加（148%，P =.01）。运动训练后以及3.5年后，烧伤儿童的心肺适能均较低（分别为75%；P <.0001和87%；P <.001）。出院后峰值扭矩（60%；P <.0001）和平均功率输出（58%；P <.0001）较低。虽然运动训练改善了这些指标，但未能达到未烧伤健康儿童的水平（83 - 84%；P <.0001），不过在3.5年后分别维持在85%和82%（P <.0001）。
虽然康复运动训练对力量和心肺能力的益处可在烧伤后近4年维持，但未完全恢复到健康儿童的水平。尽管这一现象的潜在机制仍不明确，但这些发现表明，出院后持续运动康复干预措施的未来发展可能会进一步缩小与健康青少年的差距。
