Effect of exercise training on the frequency of contracture-release surgeries in burned children

Model System:

Burn

Reference Type:

Journal article

Accession No.:

J81107

Journal:

Annals of Plastic Surgery

Year, Volume, Issue, Page(s):

2017 , 7, 4, 346-349

Publication Website:

Abstract:

Study investigated whether intensive physical exercise (IPE) decreases the frequency of burn scar contracture-releasing procedures in upper-extremity joints in children with extensive burns. The surgical records of 184 children who had undergone axilla, elbow, and/or wrist contracture-releasing procedures were reviewed. All children were 7 years or older and had sustained burns of at least 40 percent of the total body surface area. Eighty-two children completed an IPE program, and 102 children did not. The IPE program consisted of progressive, resistive, and aerobic exercise lasting 12 weeks. Children in the non-IPE group underwent a standard rehabilitative therapy consisting of physical therapy and occupational therapy. For both groups, the axilla, elbow, and wrist were examined for tightness and restricted movement. Children with contractural difficulty were prescribed a releasing procedure. Logistic regression was used to model the relationship between multiple release surgeries and group. Patients in both groups had comparable injury severity. A total of 120 releases were carried out in the 82 IPE patients. In contrast, 211 releases were needed in the 102 non-IPE patients. An approximately 60-percent decrease in the frequency of rerelease operations was noted in IPE patients (12.5 percent for the IPE group and 31.8 percent for non-IPE group). The findings suggest that, when used as an adjunct therapy in post-burn rehabilitation, IPE may be useful for reducing the need for contracture release. The mechanisms underlying the beneficial effects of exercise remain undefined and should be investigated.

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