Τετάρτη 31 Ιανουαρίου 2018

Effects of community-based exercise in adults with severe burns: a randomized controlled trial

Publication date: Available online 31 January 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Charles D. Voigt, Guillermo Foncerrada, Raquel Peña, Ashley N. Guillory, Clark R. Andersen, Craig G. Crandall, Steven E. Wolf, David N. Herndon, Oscar E. Suman
ObjectiveTo investigate the efficacy of community-based exercise programs (COMBEX) in the rehabilitation of adult burn patients as compared to standard of care (SOC).DesignRandomized controlled trial, with 2:1 randomization.SettingAssessments were performed in a hospital setting. The intervention was performed in a community setting.ParticipantsAdult patients with ≥ 30% total body surface area burns were randomized to participate in COMBEX (N = 31) or standard of care (SOC) (N = 14). Patient sampling was consecutive and referred.InterventionsThe COMBEX program consisted of 12 weeks of exercise with a community-based trainer after hospital discharge. The SOC group did not receive exercise training.Main Outcome MeasuresChange in lean body mass index, peak torque, and VO2 max from discharge to 12 weeks post discharge, presented as mean ± SE.ResultsThe COMBEX group showed a significant increase in VO2 max compared to SOC (COMBEX: Δ = 7.723 ± 1.522 mL/kg/min, p = 0.0006; SOC: Δ = 2.200 ± 1.150 mL/kg/min, p = 0.0765; COMBEX vs SOC, p = 0.0236). The COMBEX group exhibited a significant within group increase in lean body mass index (Δ = 1.107 ± 0.431 kg/m2, p = 0.0003; SOC: Δ = 1.323 ± 0.873 kg/m2, p = 0.2808). Both groups showed significant within group increases in peak torque (COMBEX: Δ = 35.645 ± 7.566 N m, p = 0.0003; SOC: Δ = 34.717 ± 11.029 N m, p = 0.0082). No significant differences were noted between the 2 groups for LBMI or peak torque.ConclusionsPatients who participate in a community-based exercise program show significant improvements in cardiopulmonary fitness compared to standard of care, supporting the use of COMBEX as an alternative therapy to SOC in adults with severe burns.



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