Exercise in Burn Survivors

摘要 在美国，50多万人正在承受严重烧伤的长期后果 覆盖20%或更多的身体表面积，超过11,000人遭受这种伤害 每年。这些烧伤会严重影响体温调节，因为永久性的 散热所需的主要热效应器受损，即皮肤血液严重钝化 受伤皮肤的流动和出汗反应。我们认为这种高温耐受性阻止了烧伤幸存者 从参加体力活动，包括日常生活活动中，避免必要的不良影响 久坐生活方式的心血管和新陈代谢后遗症。与假设相符，在受伤数年后 烧伤幸存者的有氧能力非常低；全因死亡率较高；住院天数较长 对于循环系统疾病；并遭受更多的缺血性心脏病，心力衰竭，糖尿病， 与匹配的非烧伤队列相关的脑血管疾病(包括中风)。的主要目标是 这个项目是为了找出减缓人体皮肤和核心体温过高的方法。 痊愈的烧伤幸存者的体力活动。这些模式的实施将消除高温。 不容忍是参与改善/维持心血管健康所必需活动的障碍 在这个脆弱的人群中。将解决两个具体目标：目标1将调查皮肤增加 潮湿，无论有没有伴随风扇的使用，都会恢复原本受损的油井蒸发冷却。 治愈的烧伤幸存者，改善的程度取决于环境条件和 烧伤的身体表面积的百分比。目标2将开发和验证个性化预测模型，该模型 告知烧伤幸存者安全性(或缺乏安全性)，以参加基于她/他的身体活动 独特的生理特征和盛行的环境条件。该型号将被移植到 这款智能手机应用程序将免费分发给烧伤幸存者社区、他们的家人和他们 照顾者。这项工作的预期成果将最终产生新的模式/技术，以 通过消除热不耐受来促进烧伤幸存者的身体活动，以此来阻止他们进行这样的活动 活动。具体地说，获得的知识和相关的智能手机应用程序将有助于燃烧 幸存者意识到体育锻炼的重要好处，包括降低心血管风险和 相关的发病率和死亡率的降低，生活质量的提高，更强的工作和执行能力 日常生活功能，并随着年龄的增长增强独立性。

Abstract Within the United States, 500,000+ individuals are enduring the long-term consequences of severe burn injuries covering 20% or more of their body surface area, with upwards to 11,000 individuals experiencing such an injury per year. These burn injuries can severely compromise body temperature regulation, owing to permanent impairments in the primary thermoeffectors necessary to dissipate heat, namely profoundly blunted skin blood flow and sweating responses in the injured skin. We propose that this heat intolerance deters burn survivors from participating in physical activity, including activities of daily living, necessary to avoid the adverse cardiovascular and metabolic sequela of a sedentary lifestyle. Consistent with hypothesis, years after the injury burn survivors have a very low aerobic capacity; greater all-cause mortality rates; greater hospitalization days for circulatory diseases; and suffer from greater incidences of ischemic heart disease, heart failure, diabetes, and cerebrovascular disease (including stroke) relative to matched non-burned cohorts. The primary goal of this project is to identify modalities to attenuate excessive elevations in skin and core body temperatures during physical activity in well-healed burn survivors. The implementation of such modalities will eliminate heat intolerance as a barrier to participation in activities that are necessary to improve/maintain cardiovascular health in this vulnerable population. Two specific aims will be addressed: Aim 1 will investigate whether increased skin wetness, with and without accompanying fan use, will restore otherwise impaired evaporative cooling of well- healed burn survivors, with the extent of that improvement predicated on the environmental conditions and the percentage of body surface area burned. Aim 2 will develop and validate a personalized prediction model which informs the burn survivor of the safety (or lack thereof) to participate in physical activity based upon her/his unique physiological characteristics and the prevailing environmental conditions. This model will be ported into a smartphone application that will be freely distributed to the burn survivor community, their families, and their caregivers. The expected outcomes of this work will culminate in new modalities/technologies directed towards promoting physical activity in burn survivors by eliminating heat intolerance as a deterrent to performing such activities. Specifically, the obtained knowledge and the associated smartphone application will help burn survivors realize important benefits of being physically active, including reduced cardiovascular risk and associated reductions in morbidity and mortality, improved quality of life, a greater ability to work and perform functions of daily living, and enhanced independence as they age.