Rivas Eric, Kleinhapl Julia, Suman-Vejas Oscar E
Microgravity Research, Axiom Space, Houston, TX 77058, USA.
Department of Surgery, Division of Surgical Science, University of Texas Medical Branch, Galveston, TX 77555, USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
Burns. 2024 Dec;50(9):107178. doi: 10.1016/j.burns.2024.05.018. Epub 2024 Jun 10.
Severe burn trauma damages resting and exercise cardiac function that may affect long term cardiovascular health. The implementation of rehabilitation exercise training (RET) soon after hospital discharge improves cardiorespiratory fitness; however, it does not fully restore aerobic capacity and presents large inter-individual variability. We tested the hypothesis that the inter-individual variability of aerobic capacity for responders (R) compared to nonresponders (NR) would differ for exercise frequency and intensity.
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 a 6-week RET program. Cardiorespiratory fitness (peak VO) was measured before and after RET. Frequency (session days/week), intensity (% peak heart rate), time (min/session), and volume (min/week) were compared between responders and non-responders. Significance was set at p < 0.05.
Sixty-four percent of the study population improved peak VO2 after RET whereas 36 % showed no improvements. Using a 2-way factorial ANOVA (group [G] × week [WK]), we found that exercise frequency and session time were similar and increased slightly over 6 weeks between R and NR (main effect for WK; P < 0.002). Exercise volume was significantly lower on week 2 for NR compared to R (G × WK interaction, P < 0.028). Exercise intensity over 6-weeks was significantly lower in the NR compared to the R group (G × WK interaction, P < 0.022).
Exercise intensity and volume may be important contributors for improving the interindividual response to exercise training for peak VO. These data suggest that the appropriate dose-response requirement for exercise intensity may be > 80 % peak heart rate and exercise volume of > 150 min per week. Further understanding of the exercise prescription will provide insights important for cardiovascular rehabilitation in children with severe burns.
Inter-individual Variability, Exercise, Pediatrics, Exercise Training.
严重烧伤创伤会损害静息和运动时的心脏功能，这可能会影响长期心血管健康。出院后尽早实施康复运动训练（RET）可改善心肺适能；然而，它并不能完全恢复有氧能力，且个体间差异很大。我们检验了这样一个假设，即与无反应者（NR）相比，有反应者（R）在有氧能力上的个体间差异在运动频率和强度方面会有所不同。
33名严重烧伤儿童（11名女性，[均值±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）（全身烧伤面积49±15%，三度烧伤面积35±22%）完成了为期6周的RET项目。在RET前后测量心肺适能（峰值VO₂）。比较有反应者和无反应者之间的频率（每周训练天数）、强度（峰值心率百分比）、时间（每次训练分钟数）和运动量（每周分钟数）。显著性设定为p<0.05。
64%的研究人群在RET后峰值VO₂有所改善，而36%的人没有改善。使用双向析因方差分析（组[G]×周[WK]），我们发现运动频率和每次训练时间在R组和NR组之间相似，且在6周内略有增加（WK的主效应；P<0.）。与R组相比，NR组在第2周的运动量显著更低（G×WK交互作用，P<0.028）。与R组相比，NR组在6周内的运动强度显著更低（G×WK交互作用，P<0.022）。
运动强度和运动量可能是改善个体对峰值VO₂运动训练反应的重要因素。这些数据表明，运动强度的适当剂量反应要求可能是>80%峰值心率，运动量>每周150分钟。对运动处方的进一步理解将为严重烧伤儿童的心血管康复提供重要见解。
个体间差异、运动、儿科学、运动训练。
