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Aerobic Fitness Is Disproportionately Low in Adult Burn Survivors Years After Injury

Ganio, Matthew S. PhD*†; Pearson, James PhD*‡; Schlader, Zachary J. PhD*; Brothers, Robert Matthew PhD; Lucas, Rebekah A.I. PhD*‖; Rivas, Eric MS*; Kowalske, Karen J. MD*; Crandall, Craig G. PhD*

doi: 10.1097/BCR.0b013e3182a22915
Original Articles

A maximal aerobic capacity below the 20th percentile is associated with an increased risk of all-cause mortality (Blair 1995). Adult Adult burn survivors have a lower aerobic capacity compared with nonburned adults when evaluated 38 ± 23 days postinjury (deLateur 2007). However, it is unknown whether burn survivors with well-healed skin grafts (ie, multiple years postinjury) also have low aerobic capacity. This project tested the hypothesis that aerobic fitness, as measured by maximal aerobic capacity (VO2max), is reduced in well-healed adult burn survivors when compared with normative values from nonburned individuals. Twenty-five burn survivors (36 ± 12 years old; 13 females) with well-healed split-thickness grafts (median, 16 years postinjury; range, 1–51 years) covering at least 17% of their BSA (mean, 40 ± 16%; range, 17–75%) performed a graded cycle ergometry exercise to test volitional fatigue. Expired gases and minute ventilation were measured via a metabolic cart for the determination of VO2max. Each subject’s VO2max was compared with sex- and age-matched normative values from population data published by the American College of Sports Medicine, the American Heart Association, and recent epidemiological data (Aspenes 2011). Subjects had a VO2max of 29.4 ± 10.1 ml O2/kg body mass/min (median, 27.5; range, 15.9–53.3). The use of American College of Sports Medicine normative values showed that mean VO2max of the subjects was in the lower 24th percentile (median, 10th percentile). A total of 88% of the subjects had a VO2max below American Heart Association age-adjusted normative values. Similarly, 20 of the 25 subjects had a VO2max in the lower 25% percentile of recent epidemiological data. Relative to nongrafted subjects, 80 to 88% of the evaluated skin-graft subjects had a very low aerobic capacity. On the basis of these findings, adult burn survivors are disproportionally unfit relative to the general U.S. population, and this puts them at an increased risk of all-cause mortality (Blair 1995).

From the *University of Texas Southwestern Medical Center at Dallas and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas; Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR; School of Health Sciences, Cardiff Metropolitan University, United Kingdom; §Department of Kinesiology and Health Education, University of Texas, Austin; and Centre for Global Health Research, Umea University, Sweden.

This work was supported by the National Institutes of General Medical Sciences Grant GM068865.

The authors declare no conflict of interest.

Address correspondence to Craig G. Crandall, PhD, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Ave, Dallas, TX 75231.

© 2015 The American Burn Association