Effect of Exercise Training on the Frequency of Contracture-Release Surgeries in Burned Children

• Published in: Annals of plastic surgery Vol. 79; no. 4; p. 346
• Main Authors: Lee, Jong O, Herndon, David N, Andersen, Clark, Suman, Oscar E, Huang, Ted T
• Format: Journal Article
• Language: English
• Published: United States 01.10.2017
• Subjects: Adolescent; Axilla - surgery; Burns - complications; Burns - rehabilitation; Child; Cicatrix - complications; Cicatrix - rehabilitation; Combined Modality Therapy; Contracture - etiology; Contracture - therapy; Elbow - surgery; Exercise Therapy - methods; Female; Follow-Up Studies; Humans; Logistic Models; Male; Reconstructive Surgical Procedures - statistics & numerical data; Wrist - surgery
• ISSN: 1536-3708
• DOI: 10.1097/SAP.0000000000001071

Intensive physical exercise (IPE) increases strength, lean body mass, aerobic capacity, and range of motion in children with extensive burns. However, whether IPE decreases the frequency of burn scar contracture-releasing procedures in children with extensive burns is unknown. Prospectively collected 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% of the total body surface area. Eighty-two children completed an IPE program, and 102 children did not. 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% decrease in the frequency of rerelease operations was noted in IPE patients (12.5% for the IPE group and 31.8% for non-IPE group; P < 0.05). When used as an adjunct therapy in postburn 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.