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运动训练对急性烧伤成年人肌肉减少症、肌肉力量和生活质量的影响。

Effects of exercise training on muscle wasting, muscle strength and quality of life in adults with acute burn injury.

机构信息

Multidisciplinary Metabolic Research Unit (M2RUN), MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.

Multidisciplinary Metabolic Research Unit (M2RUN), MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.

出版信息

Burns. 2023 Nov;49(7):1602-1613. doi: 10.1016/j.burns.2023.04.003. Epub 2023 Apr 23.

Abstract

OBJECTIVES

Exercise training during the acute phase of burns is difficult to implement but offers potential benefits. This multicenter trial explored the effects of an exercise program on muscular changes and quality of life during burn center stay.

METHODS

Fifty-seven adults with burns ranging between 10% and 70% TBSA were allocated to receive either standard of care (n = 29), or additionally exercise (n = 28), consisting of resistance and aerobic training, commenced as early as possible according to safety criteria. Muscle wasting (primary outcome), quantified by ultrasound-derived quadriceps muscle layer thickness (QMLT) and rectus femoris cross-sectional area (RF-CSA), muscle strength and quality of life (Burn Specific Health Scale-Brief (BSHS-B) and EQ-5D-5L) were assessed at baseline, four and eight weeks later, or hospital discharge. Mixed models were used to analyze between-group changes over time with covariates of interest added in stepwise forward modeling.

RESULTS

The addition of exercise training to standard of care induced significant improvements in QMLT, RF-CSA, muscle strength and the BSHS-B subscale hand function (ß-coefficient. 0.055 cm/week of QMLT, p = 0.005). No added benefit was observed for other quality-of-life measures.

CONCLUSIONS

Exercise training, administered during the acute phase of burns, reduced muscle wasting, and improved muscle strength throughout burn center stay.

摘要

目的

在烧伤急性期进行运动训练很困难,但有潜在的益处。这项多中心试验探讨了运动方案对烧伤中心住院期间肌肉变化和生活质量的影响。

方法

将 57 名烧伤面积在 10%至 70% TBSA 之间的成年人随机分配接受标准护理(n=29)或额外的运动(n=28),根据安全标准尽早开始进行包括抗阻和有氧运动训练。肌肉减少(主要结局)通过超声测量股四头肌肌层厚度(QMLT)和股直肌横截面积(RF-CSA)来量化,肌肉力量和生活质量(烧伤特有的健康量表-简明版(BSHS-B)和 EQ-5D-5L)在基线、4 周和 8 周后或出院时进行评估。使用混合模型分析组间随时间的变化,并逐步向前建模添加感兴趣的协变量。

结果

在标准护理的基础上增加运动训练可显著改善 QMLT、RF-CSA、肌肉力量和 BSHS-B 手功能亚量表(QMLT 每增加 0.055cm/周,p=0.005)。其他生活质量指标没有观察到额外的益处。

结论

在烧伤急性期进行运动训练可减少肌肉减少,并在烧伤中心住院期间提高肌肉力量。

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