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Kamel NM, Toson RA, Elsayeh SM. Response of Aerobic Capacity to Low-Level Laser Therapy in Burned Patients. J Burn Care Res 2021; 43:685-690. [PMID: 34520536 DOI: 10.1093/jbcr/irab173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Severe burns lead to decreased pulmonary function and impaired aerobic capacity for long periods post-injury. Low-level laser therapy is a modality utilized to improve aerobic capacity, enhance exercise performance and increase time until fatigue when utilized before aerobic exercises. PURPOSE This work aims to determine the impacts of pre-exercise low-level laser therapy on aerobic capacity in burn cases. PARTICIPANTS AND METHODS Sixty adults burned cases of both sexes, aged from 25 to 40 years, with second-degree healed thermal burns, and the total burned body surface area ranged from 20 to 40% participated in this study after complete wound healing. They were randomly categorized into two groups of equal numbers. The study group received low-level laser therapy before aerobic exercises, three sessions/week for 12 weeks, while the control group performed aerobic exercises three times weekly for 12 weeks. All cases received the routine physical treatment program. Aerobic capacity was assessed for both groups by measuring maximum oxygen consumption and time to exhaustion at baseline and twelve weeks following interventions. FINDINGS There was a statistically significant rise in the mean values of maximum oxygen usage and time to fatigue after 12 weeks of treatment in both groups. However, after comparison, the improvements in the study group were statistically significant than those in the control group with (p < 0.01), (p < 0.05) respectively. CONCLUSION Low-level laser therapy has a beneficial therapeutic impact on promoting aerobic capacity, improving maximum oxygen consumption, and increasing treadmill time in burned cases when preceding aerobic exercises.
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Affiliation(s)
- Noha Mohamed Kamel
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Rokaia Ali Toson
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Shaimaa Mohamed Elsayeh
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Bayuo J, Wong FKY. Intervention Content and Outcomes of Postdischarge Rehabilitation Programs for Adults Surviving Major Burns: A Systematic Scoping Review. J Burn Care Res 2021; 42:651-710. [PMID: 32608488 DOI: 10.1093/jbcr/iraa110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Improvement in burn care has led to more patients surviving the injury but has also led to more burn survivors requiring rehabilitation for a protracted period after discharge. Thus, this review sought to map the intervention content and outcomes associated with existing postdischarge rehabilitation programs for adults surviving major burns. A systematic scoping review approach was utilized. The Template for Intervention Description and Replication (TIDieR) and core outcome set for adult burn survivors were used to guide data extraction following which a narrative synthesis was undertaken. In all, 23 papers were retained in the review. Following discharge and up to 1 year postburn, the components of the rehabilitation programs comprised of physical, psychological, and social components. Beyond 1 year postburn, the rehabilitation programs demonstrated a preponderance of physical therapies. Support for family members was not highlighted in the included studies. Outcomes of rehabilitation programs up to 1 year postburn covered the seven core outcome domains. Outcomes associated with rehabilitation programs beyond 1 year postburn were, however, limited to the perceived quality of life, neuromuscular, and physical role functioning domains. Although most studies reported statistically significant findings, the outcome measures varied across studies which makes it difficult to draw overarching conclusions. The findings suggest that long-term rehabilitation programs for adult burn survivors are lacking. More robust studies are also needed to examine community participation outcomes associated with burns rehabilitation programs. The nature of burns and its far-reaching consequences suggest a patient- and family-centered approach to rehabilitation.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
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Özkal Ö, Topuz S, Karahan S, Erdem MM, Konan A, Yastı AÇ. Clinical predictors of pulmonary functions, respiratory/peripheral muscle strength and exercise capacity at discharge in adults with burn injury. Disabil Rehabil 2020; 43:2875-2881. [DOI: 10.1080/09638288.2020.1720320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Özden Özkal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Semra Topuz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Melek Merve Erdem
- School of Güneysu Physical Therapy and Rehabilitation, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Ali Konan
- Department of General Surgery, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ahmet Çınar Yastı
- Clinic of Burn, Ankara Numune Training and Research Hospital, Ankara, Turkey
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Ozkal O, Yurdalan SU, Seyyah M, Acar HA. The effect of burn severity on functional capacity in patients with burn injury. J Back Musculoskelet Rehabil 2019; 32:215-221. [PMID: 30248034 DOI: 10.3233/bmr-171106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Burns are traumatic injuries that result in severe tissue damage. A reduction in exercise capacity is the most common functional impairment, although it is not clear to what extent the severity of the burn injury affects the exercise capacity. OBJECTIVE The aim of this study was to examine the physiological responses to exercise and to evaluate exercise capacity according to burn severity. METHODS The study included a total of 64 burn patients, comprising 33 with moderate injuries (Total body surface area: 9.93 ± 4.73%; mean age: 37 ± 11.93 years) and 31 with major injuries (Total body surface area: 39.03 ± 10.36%; mean age: 41.09 ± 14.96 years). Heart rate, systolic blood pressure, diastolic blood pressure, double product, dyspnea level, oxygen saturation and leg fatigue before and after the shuttle walk test were recorded. Walking distances were measured after the shuttle walk test. RESULTS A significant difference was determined between patients with major and moderate burn injuries in respect of the cardiovascular responses to the shuttle walk test. Major burn injury patients had a significantly shorter walking distance than the moderate burn injury patients (p< 0.05). CONCLUSIONS Burn injury severity was seen to affect the functional capacity and cardiovascular responses to the shuttle walk test. Shuttle walk test can be preferred to evaluate moderate and major burn injury patients' functional capacity in the acute period of injury.
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Affiliation(s)
- Ozden Ozkal
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Saadet Ufuk Yurdalan
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Mine Seyyah
- Burn and Wound Treatment Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Hakan Ahmet Acar
- Burn and Wound Treatment Department, Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey
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Determination of lymphocytes surface markers in patients with thermal burns and the influence of burn size on mononuclear cell subsets. Med J Islam Repub Iran 2017; 31:38. [PMID: 29445667 PMCID: PMC5804437 DOI: 10.14196/mjiri.31.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Indexed: 12/27/2022] Open
Abstract
Background: Thermal burn injuries impair the host defence system. Hence, in the present study, we aimed at investigating the changes in the number and phenotype of peripheral blood lymphocyte populations (T, B, and natural killer cells) and their subpopulations in patients with thermal burns and determining the relationships with different sizes of total body surface area (TBSA). Methods: Blood samples from 67 patients, admitted to Motahary Burn Center in Tehran, with burns from 30% to more than 70% TBSA were collected on Days 3 and 7 postburn. Lymphocytes and their subpopulations were identified by monoclonal antibodies. The cells were analyzed using flow cytometry. The results were compared with healthy controls. Results: In this study, 3 and 7 days after burn injury, the percentages of CD3+, CD4+ and CD8+ lymphocyte significantly decreased, CD4+/CD8+ ratios were below the normal range, and CD19+ (B cells) significantly increased. No significant difference was obtained in the mean percentage of CD16+ (NK cells) between Days 3 and 7 postburn. Patients with burns of 30% TBSA or greater (>70%) had a significant reduction in CD3+, CD4+ and CD8+ ( T cells) numbers up to 7 days compared with 3 days after burn injury. Patients with 30% to >70 % TBSA burn failed to show any significant changes in CD4+/CD8+ ratio as well as CD16+ (NK cells) 3 to 7 days after burn. In patients with burns more than 30% to>70% TBSA, CD19+ (B cells) number changes were found to be complicated after 3 and 7 days. Conclusion: The results of this study suggest that alterations of immune cell surface markers and TBSA% can reflect postburn lymphocyte activation.
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Jurio-Iriarte B, Gorostegi-Anduaga I, Aispuru GR, Pérez-Asenjo J, Brubaker PH, Maldonado-Martín S. Association between Modified Shuttle Walk Test and cardiorespiratory fitness in overweight/obese adults with primary hypertension: EXERDIET-HTA study. ACTA ACUST UNITED AC 2017; 11:186-195. [DOI: 10.1016/j.jash.2017.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 01/16/2017] [Accepted: 01/27/2017] [Indexed: 12/20/2022]
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Examination of the Life Expectancy of Patients with Burns over 20% of Their Total Body Surface Area in Comparison to the Rest of the Population. J Burn Care Res 2017; 38:e906-e912. [DOI: 10.1097/bcr.0000000000000519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jürgensen S, Trimer R, Di Thommazo-Luporini L, Dourado V, Bonjorno-Junior J, Oliveira C, Arena R, Borghi-Silva A. Does the incremental shuttle walk test require maximal effort in young obese women? Braz J Med Biol Res 2016; 49:S0100-879X2016000800703. [PMID: 27409333 PMCID: PMC4954735 DOI: 10.1590/1414-431x20165229] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 05/05/2016] [Indexed: 02/01/2023] Open
Abstract
Obesity is a chronic disease with a multifaceted treatment approach that includes nutritional counseling, structured exercise training, and increased daily physical activity. Increased body mass elicits higher cardiovascular, ventilatory and metabolic demands to varying degrees during exercise. With functional capacity assessment, this variability can be evaluated so individualized guidance for exercise training and daily physical activity can be provided. The aim of the present study was to compare cardiovascular, ventilatory and metabolic responses obtained during a symptom-limited cardiopulmonary exercise test (CPX) on a treadmill to responses obtained by the incremental shuttle walk test (ISWT) in obese women and to propose a peak oxygen consumption (VO2) prediction equation through variables obtained during the ISWT. Forty obese women (BMI ≥30 kg/m2) performed one treadmill CPX and two ISWTs. Heart rate (HR), arterial blood pressure (ABP) and perceived exertion by the Borg scale were measured at rest, during each stage of the exercise protocol, and throughout the recovery period. The predicted maximal heart rate (HRmax) was calculated (210 - age in years) (16) and compared to the HR response during the CPX. Peak VO2 obtained during CPX correlated significantly (P<0.05) with ISWT peak VO2 (r=0.79) as well as ISWT distance (r=0.65). The predictive model for CPX peak VO2, using age and ISWT distance explained 67% of the variability. The current study indicates the ISWT may be used to predict aerobic capacity in obese women when CPX is not a viable option.
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Affiliation(s)
- S.P. Jürgensen
- Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - R. Trimer
- Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - L. Di Thommazo-Luporini
- Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - V.Z. Dourado
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - J.C. Bonjorno-Junior
- Departamento de Medicina, Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C.R. Oliveira
- Departamento de Medicina, Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - R. Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA
| | - A. Borghi-Silva
- Laboratório de Fisioterapia Cardiopulmonar, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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Practice Guidelines for Cardiovascular Fitness and Strengthening Exercise Prescription After Burn Injury. J Burn Care Res 2016; 37:e539-e558. [DOI: 10.1097/bcr.0000000000000282] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gonçalves CG, Mesquita R, Hayashi D, Merli MF, Vidotto LS, Fernandes KBP, Probst VS. Does the Incremental Shuttle Walking Test require maximal effort in healthy subjects of different ages? Physiotherapy 2014; 101:141-6. [PMID: 25700634 DOI: 10.1016/j.physio.2014.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 11/04/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate if the Incremental Shuttle Walking Test (ISWT) requires maximal effort in healthy subjects of different ages. DESIGN Cross-sectional. SETTING University-based research laboratory. PARTICIPANTS 331 healthy subjects separated into six groups according to age: G1, 18 to 28 years; G2, 29 to 39 years; G3, 40 to 50 years; G4, 51 to 61 years; G5, 62 to 72 years and; G6, 73 to 83 years. MAIN OUTCOME MEASURES Two ISWTs were performed and participants were permitted to run and to exceed 12 levels during the test, if necessary. Heart rate (HR) and symptoms of dyspnoea and fatigue were recorded before and after the test, and the percentage of age-predicted maximal HR (HRmax) was calculated. Maximal effort was defined as HRmax >90% of age-predicted HRmax. RESULTS Almost 31% of the subjects exceeded 12 levels in the ISWT. At the end of the test, all groups presented a median [interquartile range] HR greater than 90% of HRmax (G1: 100 [95 to 104]; G2: 100 [96 to 105]; G3: 103 [97 to 108]; G4: 99 [91 to 106]; G5: 96 [87 to 106] and G6: 96 [91 to 109]% HRmax). Regarding symptoms, all groups showed higher values after the test (P<0.05). A multiple logistic regression analysis identified female gender, older age and a lower HR before the test as determinants of not achieving 90% of HRmax at the end of the test. CONCLUSIONS The ISWT requires maximal effort in healthy individuals, but for that it is necessary to extend the test beyond twelve levels. Female gender, older age and lower heart rate before the test are the determinants of not reaching maximal effort.
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Affiliation(s)
- Cristiane Golias Gonçalves
- Centro de Pesquisa em Ciências da Saúde (CPCS), Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil; Pós-graduação em Ciências da Reabilitação (Programa associado Universidade Estadual de Londrina (UEL) - Universidade Norte do Paraná (UNOPAR)), Londrina, Paraná, Brazil
| | - Rafael Mesquita
- Centro de Pesquisa em Ciências da Saúde (CPCS), Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil; Pós-graduação em Ciências da Reabilitação (Programa associado Universidade Estadual de Londrina (UEL) - Universidade Norte do Paraná (UNOPAR)), Londrina, Paraná, Brazil
| | - Daniela Hayashi
- Centro de Pesquisa em Ciências da Saúde (CPCS), Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil; Pós-graduação em Ciências da Reabilitação (Programa associado Universidade Estadual de Londrina (UEL) - Universidade Norte do Paraná (UNOPAR)), Londrina, Paraná, Brazil
| | - Myriam Fernanda Merli
- Centro de Pesquisa em Ciências da Saúde (CPCS), Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil; Pós-graduação em Ciências da Reabilitação (Programa associado Universidade Estadual de Londrina (UEL) - Universidade Norte do Paraná (UNOPAR)), Londrina, Paraná, Brazil
| | - Laís Silva Vidotto
- Centro de Pesquisa em Ciências da Saúde (CPCS), Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil; Pós-graduação em Ciências da Reabilitação (Programa associado Universidade Estadual de Londrina (UEL) - Universidade Norte do Paraná (UNOPAR)), Londrina, Paraná, Brazil
| | - Karen Barros Parron Fernandes
- Centro de Pesquisa em Ciências da Saúde (CPCS), Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil; Pós-graduação em Ciências da Reabilitação (Programa associado Universidade Estadual de Londrina (UEL) - Universidade Norte do Paraná (UNOPAR)), Londrina, Paraná, Brazil
| | - Vanessa S Probst
- Centro de Pesquisa em Ciências da Saúde (CPCS), Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil; Pós-graduação em Ciências da Reabilitação (Programa associado Universidade Estadual de Londrina (UEL) - Universidade Norte do Paraná (UNOPAR)), Londrina, Paraná, Brazil; Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brazil.
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Parreira VF, Janaudis-Ferreira T, Evans RA, Mathur S, Goldstein RS, Brooks D. Measurement properties of the incremental shuttle walk test. a systematic review. Chest 2014; 145:1357-1369. [PMID: 24384555 DOI: 10.1378/chest.13-2071] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: The incremental shuttle walk test (ISWT) was developed > 20 years ago and has been used to assess peak exercise capacity in a variety of chronic diseases. The aim of this systematic review is to describe the measurement properties of the ISWT in a clinical population.Methods: Of 800 articles identified by electronic and hand searches, 35 were included. Twenty-one articles included data on the validity of the ISWT, 18 on the reliability, four on the responsiveness,and four on the interpretability.Results: Most of the studies were conducted in patients with COPD (n = 13) or cardiac disease(n = 8). For criterion validity, comparisons between distance covered during the ISWT and peak oxygen consumption reported correlations ranging from 0.67 to 0.95 ( P <.01). Intraclass correlation coefficients for test-retest reliability ranged from 0.76 to 0.99. The ISWT was shown to be responsive to pulmonary rehabilitation and bronchodilator administration. The minimal clinically important difference (MCID) in patients with COPD was 48 m. Predictive equations for the distance in the ISWT are available for healthy individuals.Conclusions: The ISWT can be considered a valid and reliable test to assess maximal exercise capacity in individuals with chronic respiratory diseases. The ISWT has been shown to be responsive to pulmonary rehabilitation and bronchodilator use in individuals with COPD, cystic fibrosis,and asthma. Further studies examining responsiveness and the MCID of the ISWT in patients with conditions other than lung diseases are required for the interpretation of interventions in other populations.
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Affiliation(s)
- Verônica F Parreira
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; CAPES Brazil, West Park Healthcare Centre (Respiratory Medicine), Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, St. John's Rehabilitation Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Tania Janaudis-Ferreira
- Sunnybrook Health Sciences Centre, St. John's Rehabilitation Program, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Department of Infection, Immunity and Inflammation, School of Medicine, University of Leicester, Leicester, England
| | - Rachel A Evans
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sunita Mathur
- Sunnybrook Health Sciences Centre, St. John's Rehabilitation Program, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Infection, Immunity and Inflammation, School of Medicine, University of Leicester, Leicester, England
| | - Roger S Goldstein
- Sunnybrook Health Sciences Centre, St. John's Rehabilitation Program, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Infection, Immunity and Inflammation, School of Medicine, University of Leicester, Leicester, England; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dina Brooks
- Sunnybrook Health Sciences Centre, St. John's Rehabilitation Program, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Infection, Immunity and Inflammation, School of Medicine, University of Leicester, Leicester, England.
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Abstract
Exercise programs capable of contributing positively to the long-term rehabilitation of burn patients should be included in outpatient rehabilitation programs. However, the extent and intensity of the resistance and cardiopulmonary exercise prescribed are unclear. This study was conducted to investigate the existence, design, content, and prescription of outpatient cardiopulmonary and resistance exercise programs within outpatient burn rehabilitation. A survey was designed to gather information on existing exercise programs for burn survivors and to assess the extent to which these programs are included in overall outpatient rehabilitation programs. Three hundred and twenty-seven surveys were distributed in the licensed physical and occupational therapists part of the American Burn Association Physical Therapy/Occupational Therapy Special Interest Group. One hundred and three surveys were completed. Eighty-two percent of respondents indicated that their institutions offered outpatient therapy after discharge. The frequency of therapists' contact with patients during this period varied greatly. Interestingly, 81% of therapists stated that no hospital-based cardiopulmonary endurance exercise programs were available. Patients' physical function was infrequently determined through the use of cardiopulmonary parameters (oxygen consumption and heart rate) or muscle strength. Instead, more subjective parameters such as range of motion (75%), manual muscle testing (61%), and quality of life (61%) were used. Prescription and follow-up assessment of cardiopulmonary endurance training are inconsistent among institutions, underscoring the need for greater awareness of the importance of exercise in any burn rehabilitation program. Identification of cardiopulmonary and progressive resistance parameters for establishing and tracking exercise training is also needed to maximize exercise-induced benefits.
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