Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation.
Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation.
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DOI：
10.1097/bcr.0b013e3181db5317
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发表时间：
2010-05
期刊：
影响因子：
--
通讯作者：
Suman OE
中科院分区：
文献类型：
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作者：
Al-Mousawi AM;Williams FN;Mlcak RP;Jeschke MG;Herndon DN;Suman OE
严重烧伤引起严重的激素和代谢紊乱，导致高代谢，反映在静息能量消耗（REE）和广泛的骨骼肌catalysts的极端升高。康复期间的有氧运动和抗阻运动计划已经显示出实质性的益处，尽管这种训练是否可能加剧基础代谢尚不清楚。因此，我们研究的影响，运动训练后，REE在严重烧伤的儿科患者的康复。总体表面积（TBSA）大于等于40%烧伤的儿童在入院时被纳入我们的烧伤重症监护病房，参加为期12周的医院运动计划（EX）或家庭标准护理计划（SOC），从受伤后6个月开始。21例患者（7-17岁）入组并随机分配至SOC（n=10）或EX（n=11）。年龄、性别和烧伤TBSA相似。标准化为个体瘦体重（LBM）的REE平均变化（± sd）在SOC和EX组患者之间几乎可以忽略不计（0.03 ± 17.40%，SOC vs. 0.01 ± 26.38%，EX）。发现EX患者的LBM显著增加（2.06 ± 3.17%，SOC vs. 8.75 ± 5.65%，EX; p=0.004），当标准化为身高时持续增加（0.70 ± 2.39%，SOC vs. 6.14 ± 6.46%，EX; p=0.02）。EX患者的峰值扭矩改善也更显著（12.29 ± 16.49%，SOC vs. 54.31 ± 44.25%，EX; p=0.02），反映了强度改善。运动训练显著提高瘦体重和力量，没有观察到烧伤后高代谢的恶化。因此，我们提倡使用运动调节作为小儿烧伤康复的一个安全有效的组成部分。
Severe burns cause profound hormonal and metabolic disturbances resulting in hypermetabolism, reflected in extreme elevation of resting energy expenditure (REE) and extensive skeletal muscle catabolism. Aerobic and resistive exercise programs during rehabilitation have shown substantial benefits, although whether such training potentially exacerbates basal metabolism is unknown. We therefore examined the effects of exercise training upon REE during the rehabilitation of severely burned pediatric patients. Children with 40% total body surface area (TBSA) burns and greater were enrolled on admission to our burn intensive-care unit to participate in a twelve-week, hospital-based exercise program (EX), or a home-based standard of care program (SOC), commencing six months post-injury. Twenty-one patients (7–17 years) were enrolled and randomized to SOC (n=10) or EX (n=11). Age, gender, and TBSA burned were similar. Mean change (± sd) in REE, normalized to individual lean body mass (LBM), was almost negligible between SOC and EX group patients (0.03 ± 17.40%, SOC vs. 0.01 ± 26.38%, EX). A significant increase in LBM was found for EX patients (2.06 ± 3.17%, SOC vs. 8.75 ± 5.65%, EX; p=0.004), which persisted when normalized to height (0.70 ± 2.39%, SOC vs. 6.14 ± 6.46%, EX; p=0.02). Peak torque also improved significantly more in EX patients (12.29 ± 16.49%, SOC vs. 54.31 ± 44.25%, EX; p=0.02), reflecting improved strength. Exercise training significantly enhanced lean mass and strength, without observed exacerbation of post-burn hypermetabolism. We therefore advocate use of exercise conditioning as a safe and effective component of pediatric burn rehabilitation.