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Effect of a Supervised Exercise and Physiotherapy Program on Surgical Interventions in Children with Thermal Injury

Celis, Mario M. PA-C; Suman, Oscar E. PhD; Huang, Ted T. MD; Yen, Peter PA-C; Herndon, David N. MD

Features: Burn Rehabilitation Forum

Continuous body growth and rigidity of scars in children are significant contributors to burn scar contractures (BSCs). BSCs decrease a patient’s range of motion and their ability to perform activities of daily living. A benefit of exercise is an increase the patient’s ability to perform and sustain activities of daily living. Therefore, we investigated whether patients who were involved in a supervised, hospital-based exercise program, in addition to physical and occupational therapy (PTEX), would have fewer surgical interventions than a nonexercise group receiving home-delivered physical and occupational therapy (PT) alone. We examined 53 patients at 6, 9, 12, 18, and 24 months postburn. The PTEX group (n = 27) completed a 12-week supervised exercise program starting at 6 months postburn. Exercise sessions were held three times per week, with duration of 60 to 90 minutes per session. Resistance and aerobic exercises were performed at 70 to 85% of the patient’s maximal effort. In contrast, the PT group (n = 26) received a home rehabilitation program with no supervised exercise. Patients were evaluated at 3-month intervals for scar formation, range of motion, and need for surgery. At 12, 18, 24 months postburn, the number of patients in the PTEX group needing release of BSC was significantly lower than the number of patients in the PT group. The results indicate that patients would receive a significant benefit if enrolled in a supervised exercise and physiotherapy program with the exercise portion consisting of an aerobic and resistance-training component. This type of program is beneficial in decreasing the number of surgical interventions and should be incorporated as part of a postburn outpatient rehabilitation.

From the Department of Surgery, Medical Staff Administration, Shriners Hospitals for Children, The University of Texas Medical Branch, Galveston, Texas.

Address correspondence to David N. Herndon, MD, Chief of Staff, Shriners Hospitals for Children, 815 Market Street, Galveston, Texas 77550.

Supported by a grant from the National Institute for Disabilities and Rehabilitation Research (H133A70019) and a grant from the National Institutes of Health (1 P50 GM06338–01).

©2003The American Burn Association