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Practice Guidelines for Cardiovascular Fitness and Strengthening Exercise Prescription After Burn Injury

Nedelec, Bernadette BSc OT(c), PhD; Parry, Ingrid MS, PT; Acharya, Hernish BSc, MD, FRCPC; Benavides, Lynne OT/CHT; Bills, Sara PT; Bucher, Janelle L. OTR/L; Cheal, Joanne BMR, OT; Chouinard, Annick BSc, PT; Crump, Donna PT; Duch, Sarah PT; Godleski, Matthew MD; Guenther, Jennifer MSPT; Knox, Catherine OTR/L; LaBonte, Eric PT; Lorello, David DPT; Lucio, J. Xavier MS OTR/L; Macdonald, Lori E. MSc PT; Kemp-Offenberg, Jennifer OTR/L; Osborne, Candice OT; Pontius, Kara PT; Yelvington, Miranda MS,OTR/L, BCPR; de Oliveira, Ana BSc; Kloda, Lorie A. BA, MLIS, PhD

doi: 10.1097/BCR.0000000000000282
Original Articles

The objective of this review was to systematically evaluate the available clinical evidence for the prescription of strength training and cardiovascular endurance exercise programs for pediatric and adult burn survivors so that practice guidelines could be proposed. This review provides evidence-based recommendations specifically for rehabilitation professionals who are responsible for burn survivor rehabilitation. Summary recommendations were made after the literature was retrieved by systematic review, was critically appraised by multiple authors and the level of evidence determined in accordance with the Oxford Centre for Evidence-based Medicine criteria.1 Although gaps in the literature persist and should be addressed in future research projects, currently, strong research evidence supports the prescription of strength training and aerobic conditioning exercise programs for both adult and pediatric burn survivors when in the presence of strength limitations and/or decreased cardiovascular endurance after evaluation.

From the *School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada; Centre de recherche, Centre hospitalier de l’Université de Montréal (CRCHUM), Quebec, Canada; Hôpital de réadaptation Villa Medica, Montreal, Quebec, Canada; §Shriners Hospitals for Children, Northern California, Sacramento; Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada; Rhode Island Hospital, Rehabilitation Medicine, Providence; #University of Nebraska Medical Center, Omaha, Nebraska; **University of Washington, Seattle, Washington; ††Alberta Health Services, Foothills Medical Centre, Calgary, Canada; ‡‡Parkland Health & Hospital System, Dallas, Texas; §§Westchester Medical Center, Valhalla, New York; ‖‖Medical Director of Inpatient Rehabilitation, University of Colorado Hospital, Aurora, Colorado; ¶¶Children’s Hospital Colorardo, Aurora, Colorado; ##Connecticut Burn Center, Bridgeport Hospital, Bridgeport, Connecticut; ***Arizona Burn Center, Phoenix, Arizona; †††University of Utah Burn Center, Salt Lake City, Utah; ‡‡‡Shriners Hospitals for Children, Galveston, Texas; §§§University of Texas Medical Branch, Galveston, Texas; ‖‖‖Arkansas Children’s Hospital Burn Center, Little Rock, Arkansas; and ¶¶¶Library, McGill University, Montreal, Quebec, Canada.

This study was supported by the Edith and Richard Strauss Foundation.

Address correspondence to Bernadette Nedelec, PhD, McGill University, Faculty of Medicine, 3654 Promenade Sir William Osler, Montreal, Quebec, Canada H3G 1Y5. E-mail:

© 2016 The American Burn Association