Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation

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Study examined the effects of exercise training on resting energy expenditure (REE) during the rehabilitation of severely burned pediatric patients. Severe burns cause profound hormonal and metabolic disturbances resulting in hypermetabolism, reflected in extreme elevation of REE and extensive skeletal muscle catabolism. Twenty-one patients (aged 7 to 17 years) with 40 percent and greater total body surface area burns participated in the study. Participants were randomized at admission to the burn intensive care unit to either a 12-week, hospital-based exercise program (EX) or a home-based standard of care program (SOC), commencing 6 months after injury. Age, sex, and total body surface area burned were similar. Mean change in REE, normalized to individual lean body mass, was almost negligible between SOC and EX group patients. A significant increase in lean body mass was found for EX patients, which persisted when normalized to height. Peak torque also improved significantly more in EX patients, reflecting improved strength. Exercise training significantly enhanced lean mass and strength, without observed exacerbation of postburn hypermetabolism. Therefore, the use of exercise conditioning as a safe and effective component of pediatric burn rehabilitation is recommended.

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