In 2014, a groundbreaking study has demonstrated the significant benefits of early outpatient exercise on muscle mass, function, and synthetic rates in severely burned children. Conducted by Justin P. Hardee, Craig Porter, Labros S. Sidossis, Elisabet Børsheim, James A. Carson, David N. Herndon, and Oscar E. Suman, the research underscores the crucial role of rehabilitative exercise in enhancing recovery outcomes.

The study involved 47 children who had sustained burns covering at least 40% of their total body surface area. These children were divided into two groups following their hospital discharge: one group received standard care rehabilitation (SOC, n = 23), while the other participated in a rehabilitative exercise training program (RET, n = 24) over a 12-week period.

To measure the impact of the interventions, the researchers used dual-energy x-ray absorptiometry to assess lean body mass (LBM) at discharge, posttreatment, and 12 months post-burn. Muscle function was evaluated using a Biodex Isokinetic Dynamometer, and peak aerobic fitness (V˙O2peak) was assessed with a modified Bruce treadmill protocol posttreatment. Additionally, stable isotope infusion studies were conducted on a subset of patients (SOC, n = 13; RET, n = 11) to determine mixed-muscle fractional synthetic rates.

The results revealed remarkable improvements in the RET group compared to the SOC group:

• Muscle Function and Aerobic Fitness: The RET group exhibited significantly higher relative peak torque (138 ± 9 N·m·kg vs. 106 ± 9 N·m·kg) and V˙O2peak (32 ± 1 mL·kg·min vs. 28 ± 1 mL·kg·min) posttreatment.
• Lean Body Mass: Whole-body LBM increased by 9% ± 2%, and leg LBM increased by 17% ± 3% in the RET group, compared to the SOC group. Over the longer term, the RET group showed a greater percentage increase in whole-body LBM (18% ± 3%) and leg LBM (31% ± 4%) from discharge to 12 months post-burn.
• Muscle Fractional Synthetic Rate: While both groups experienced a decrease in muscle fractional synthetic rates from discharge to posttreatment (6.9% ± 1.1% per day vs. 3.4 ± 0.4% per day), there were no significant differences between the RET and SOC groups at each time point.

The study’s findings highlight the effectiveness of early outpatient exercise training as a critical intervention for improving muscle mass and function in children recovering from severe burn injuries. Implementing such exercise regimens immediately after hospital discharge could significantly enhance recovery outcomes, offering a promising avenue for pediatric burn rehabilitation.

Reference: Hardee, J. P., Porter, C., Sidossis, L. S., Børsheim, E., Carson, J. A., Herndon, D. N., & Suman, O. E. (2014). Early rehabilitative exercise training in the recovery from pediatric burn. Medicine and science in sports and exercise, 46(9), 1710.