Huo T, Ruan J J, Jiang M J, Lei F, Huang W, Tang W Q, Xie W G, Xu X Y, Wang S, Liu S H
Department of Burns, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan 430060, China.
Department of Radiology, Liyuan Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China.
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Dec 20;39(12):1131-1139. doi: 10.3760/cma.j.cn501225-20230729-00022.
To explore the effects of resistance training with elastic band at home on muscle function and walking ability of severely burned children. A prospective non-randomized controlled study was conducted. From January 2022 to April 2023, 40 children with severe burns who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital. According to the willingness of the children or their families, the children were assigned to conventional rehabilitation group and combined rehabilitation group. During the study, 8 children dropped out of the study, 17 children were finally included in the conventional rehabilitation group with 6 males and 11 females, aged (8.5±2.4) years, and 15 children were included in the combined rehabilitation group with 5 males and 10 females, aged (9.6±2.5) years. The children in the 2 groups received conventional burn rehabilitation treatment in the hospital, including active and passive activity training, scar massage, and pressure therapy. The children in combined rehabilitation group received resistance training with elastic band of 3 to 5 times per week after discharge, and the children in conventional rehabilitation group received daily activity ability training after discharge. Before home rehabilitation training (1 week before discharge) and 12 weeks after home rehabilitation training, the grip strength was measured using a handheld grip dynamometer, the muscle strengths of the upper and lower limbs were measured using a portable dynamometer for muscle strength, lean body mass was measured by bioelectrical impedance measuring instrument, and the 6-min walking distance was measured. Data were statistically analyzed with independent sample test, paired sample test, Mann-Whitney test, or Fisher's exact probability test. After 12 weeks of home rehabilitation training, the grip strengths of children in combined rehabilitation group and conventional rehabilitation group were (15±4) and (11±4) kg, respectively, which were significantly higher than (10±4) and (9±4) kg before home rehabilitation training (with values of -9.99 and -11.89, respectively, values all <0.05); the grip strength of children in combined rehabilitation group was significantly higher than that in conventional rehabilitation group (=3.24, <0.05). After 12 weeks of home rehabilitation training, the muscle strengths of upper and lower limbs of children in combined rehabilitation group (with values of -11.39 and -3.40, respectively, <0.05) and the muscle strengths of upper and lower limbs of children in conventional rehabilitation group (with values of -7.59 and -6.69, respectively, <0.05) were significantly higher than those before home rehabilitation training, and the muscle strengths of upper and lower limbs of children in combined rehabilitation group were significantly higher than those in conventional rehabilitation group (with values of 3.80 and 7.87, respectively, <0.05). After 12 weeks of home rehabilitation training, the lean body mass of children in combined rehabilitation group was significantly higher than that before home rehabilitation training (=0.21, <0.05). After 12 weeks of home rehabilitation training, the 6-min walking distances of children in conventional rehabilitation group and combined rehabilitation group were significantly longer than those before home rehabilitation training (with values of -5.33 and -3.40, respectively, <0.05), and the 6-min walking distance of children in combined rehabilitation group was significantly longer than that in conventional rehabilitation group (=3.81, <0.05). Conventional burn rehabilitation treatment in hospital and home resistance training with elastic band for 12 weeks after discharge can significantly improve the muscle function and walking ability of severely burned children.
探讨家庭弹力带抗阻训练对重度烧伤患儿肌肉功能及步行能力的影响。进行一项前瞻性非随机对照研究。2022年1月至2023年4月,40例符合纳入标准的重度烧伤患儿入住武汉大学同仁医院&武汉市第三医院。根据患儿或其家属意愿,将患儿分为传统康复组和综合康复组。研究期间,8例患儿退出研究,最终传统康复组纳入17例患儿,其中男6例,女11例,年龄(8.5±2.4)岁;综合康复组纳入15例患儿,其中男5例,女10例,年龄(9.6±2.5)岁。两组患儿均在医院接受传统烧伤康复治疗,包括主动和被动活动训练、瘢痕按摩及压力治疗。综合康复组患儿出院后每周进行3至5次弹力带抗阻训练,传统康复组患儿出院后进行日常活动能力训练。在家庭康复训练前(出院前1周)及家庭康复训练12周后,使用握力计测量握力,使用便携式肌肉力量计测量上下肢肌肉力量,使用生物电阻抗测量仪测量瘦体重,并测量6分钟步行距离。数据采用独立样本t检验、配对样本t检验、Mann-Whitney U检验或Fisher确切概率检验进行统计学分析。家庭康复训练12周后,综合康复组和传统康复组患儿的握力分别为(15±4)kg和(11±4)kg,显著高于家庭康复训练前的(10±4)kg和(9±4)kg(t值分别为-9.99和-11.89,P值均<0.05);综合康复组患儿的握力显著高于传统康复组(Z=3.24,P<0.05)。家庭康复训练12周后,综合康复组患儿上下肢肌肉力量(t值分别为-11.39和-3.40,P<0.05)及传统康复组患儿上下肢肌肉力量(t值分别为-7.59和-6.69,P<0.05)均显著高于家庭康复训练前,且综合康复组患儿上下肢肌肉力量显著高于传统康复组(t值分别为3.80和7.87,P<0.05)。家庭康复训练12周后,综合康复组患儿的瘦体重显著高于家庭康复训练前(Z=0.21,P<0.05)。家庭康复训练12周后,传统康复组和综合康复组患儿的6分钟步行距离均显著长于家庭康复训练前(t值分别为-5.33和-3.40,P<0.05),且综合康复组患儿的6分钟步行距离显著长于传统康复组(Z=3.81,P<0.05)。医院内传统烧伤康复治疗及出院后12周家庭弹力带抗阻训练可显著改善重度烧伤患儿的肌肉功能及步行能力。