Inter-individual variability of aerobic capacity after rehabilitation exercise training in children with severe burn injury

IF 2.9 3区医学 Q2 CRITICAL CARE MEDICINE Burns Pub Date : 2024-12-01 Epub Date: 2024-06-10 DOI:10.1016/j.burns.2024.05.018

Eric Rivas , Julia Kleinhapl , Oscar E. Suman-Vejas

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Abstract

Introduction

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.

Methods

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 VO₂) 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.

Results

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).

Conclusions

Exercise intensity and volume may be important contributors for improving the interindividual response to exercise training for peak VO₂. 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.

Subject code

Inter-individual Variability, Exercise, Pediatrics, Exercise Training

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严重烧伤儿童康复训练后有氧运动能力的个体间差异

严重烧伤损害静息和运动心功能，可能影响长期心血管健康。出院后尽快实施康复运动训练（RET）可改善心肺功能；然而，它不能完全恢复有氧能力，并呈现出很大的个体差异。我们检验了一个假设，即反应者(R)与无反应者（NR）的有氧能力的个体间变异性会因运动频率和强度而不同。方法33例重度烧伤患儿（烧伤面积占体表总面积的49%±15%，三度烧伤面积占35%±22%）完成为期6周的RET计划，其中女性11例，[mean±SD] 12±3岁，身高145±18 cm，体重40±11 kg， BMI百分位数49±31。在RET前后测量心肺适能（峰值VO2），比较反应者和无反应者的频率（疗程天数/周）、强度（峰值心率百分比）、时间（分钟/次）和容量（分钟/周）。p <为显著性；0.05.结果64%的研究人群在RET后VO2峰值得到改善，36%的人没有改善。使用双因素方差分析（组[G] ×周[WK]），我们发现运动频率和运动时间在R和NR之间相似，并且在6周内略有增加(主要作用为WK；P & lt;0.002)。与R (G × WK相互作用，P <；0.028)。NR组6周的运动强度明显低于R组(G × WK相互作用，P <；0.022)。结论运动强度和运动量可能是提高VO2峰值运动训练个体间反应的重要因素。这些数据表明，适当的运动强度剂量反应要求可能是：80%峰值心率和运动量；每周150分钟。进一步了解运动处方将为严重烧伤儿童的心血管康复提供重要的见解。受试者代码：个体差异，运动，小儿科，运动训练

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.