Rivas Eric, Herndon David N, Cambiaso-Daniel Janos, Rontoyanni Victoria G, Porter Craig, Glover Shauna, Suman Oscar E
Department of Surgery, Shriners Hospitals for Children, University of Texas Medical Branch, Galveston, Texas.
Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas.
J Burn Care Res. 2018 Oct 23;39(6):889-896. doi: 10.1093/jbcr/iry001.
Currently, there are no clear guidelines for the implementation of rehabilitative exercise training (RET) in burned individuals. Therefore, we quantified the training logs for exercise intensity, frequency, and duration of 6 weeks of this program to develop a basic framework for outpatient RET in patients recovering from severe burns. Thirty-three children (11 female, [mean ± SD] 12 ± 3 years, 145 ± 18 cm, 40 ± 11 kg, 49 ± 31 BMI percentile) with severe burns (49 ± 15% total body surface area burned, with 35 ± 22% third-degree burns) completed our 6-week resistance and aerobic exercise training program. Cardiorespiratory fitness (peak VO2), strength, power, and lean body mass (LBM) were measured before and after RET. Outcome measures were analyzed as a relative percentage of values in age- and sex-matched nonburned children (11 female, 12 ± 3 years, 154 ± 20 cm, 49 ± 22 kg, 56 ± 25 BMI percentile). At discharge, burned children had lower LBM (77% of age-sex-matched nonburn values), peak torque (53%), power (62%), and cardiorespiratory fitness (56%). After 6 weeks of training, LBM increased by 5% (82% of nonburn values), peak torque by 18% (71%), power by 20% (81%), and cardiorespiratory fitness by 18% (74%; P < .0001 for all). Quantification of data in exercise training logs suggested that physical capacity can be improved by aerobic exercise training performed at five metabolic equivalents (>70% of peak VO2) at least 3 days/week and 150 minutes/week and by resistance training performed at volume loads (reps × sets × weight) of 131 kg for the upper body and 275 kg for the lower body for 2 days/week. We present for the first time the quantification of our RET and provide clear exercise prescription guidelines specific to children with severe burn injury.
目前,对于烧伤患者进行康复运动训练(RET)尚无明确的指导方针。因此,我们对该项目6周的运动强度、频率和时长的训练记录进行了量化,以建立一个针对严重烧伤康复患者门诊RET的基本框架。33名重度烧伤儿童(11名女性,[平均±标准差]12±3岁,身高145±18厘米,体重40±11千克,BMI百分位数49±31)(全身烧伤总面积49±15%,三度烧伤面积35±22%)完成了我们为期6周的抗阻和有氧运动训练项目。在RET前后测量了心肺适能(峰值摄氧量)、力量、功率和去脂体重(LBM)。将结果指标分析为年龄和性别匹配的未烧伤儿童(11名女性,12±3岁,身高154±20厘米,体重49±22千克,BMI百分位数56±25)相应数值的相对百分比。出院时,烧伤儿童的LBM较低(为年龄和性别匹配的未烧伤儿童数值的77%),峰值扭矩较低(53%),功率较低(62%),心肺适能较低(56%)。经过6周训练后,LBM增加了5%(为未烧伤儿童数值的82%),峰值扭矩增加了18%(71%),功率增加了20%(81%),心肺适能增加了18%(74%;所有指标P均<.0001)。运动训练记录中的数据量化表明,通过每周至少3天、每周150分钟进行相当于5个代谢当量(>峰值摄氧量的70%)的有氧运动训练,以及每周2天进行上肢131千克、下肢275千克的容量负荷(重复次数×组数×重量)抗阻训练,可以提高身体能力。我们首次展示了对我们的RET的量化,并为重度烧伤儿童提供了明确的运动处方指南。