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重度烧伤儿童运动康复计划的量化:加尔维斯顿施莱宁儿童医院的护理标准。

Quantification of an Exercise Rehabilitation Program for Severely Burned Children: The Standard of Care at Shriners Hospitals for Children®-Galveston.

作者信息

Rivas Eric, Herndon David N, Cambiaso-Daniel Janos, Rontoyanni Victoria G, Porter Craig, Glover Shauna, Suman Oscar E

机构信息

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.

出版信息

J Burn Care Res. 2018 Oct 23;39(6):889-896. doi: 10.1093/jbcr/iry001.

Abstract

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.

摘要

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。

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