Key Exercise Concepts in the Rehabilitation from Severe Burns

Overview

Journal Phys Med Rehabil Clin N Am

Specialty Rehabilitation Medicine

Date 2023 Oct 8

PMID 37806699

Authors

Eric Rivas

Josh Foster

Craig G Crandall

Celeste C Finnerty

Oscar E Suman-Vejas

Affiliations

Soon will be listed here.

Abstract

This article presents information on the benefits of exercise in counteracting the detrimental effects of bed rest, and/or severe burns. Exercise is key for maintaining physical function, lean body mass, metabolic recovery, and psychosocial health after major burn injuries. The details of an exercise training program conducted in severely burned persons are presented, as well as information on the importance of proper regulation of body temperature during exercise or physical activity. The sections on exercise and thermoregulation are followed by a section on the role of exercise in scarring and contractures. Finally, gaps in the current knowledge of exercise, thermoregulation, and contractures are presented.

Citing Articles

Electromagnetic Fields, Electrical Stimulation, and Vacuum Simultaneously Applied for Major Burn Scars.

Marafioti S, Veronese S, Pecorella C, Tavernese C, Costantino S, Busoni M Bioengineering (Basel). 2025; 12(2).

PMID: 40001698 PMC: 11852087. DOI: 10.3390/bioengineering12020179.

The Historical Evolvement of Movement and Exercise Training in Patients with Severe Burns and Their Potential Effects on Grafts, Scars, and Function.

Kleinhapl J, Knappskog K, Finnerty C, Branski L, Suman O Semin Plast Surg. 2024; 38(2):157-161.

PMID: 38746699 PMC: 11090657. DOI: 10.1055/s-0044-1785216.

References

Palackic A, Suman O, Porter C, Murton A, Crandall C, Rivas E . Rehabilitative Exercise Training for Burn Injury. Sports Med. 2021; 51(12):2469-2482. PMC: 8595583. DOI: 10.1007/s40279-021-01528-4. View

Stiller K . Safety issues that should be considered when mobilizing critically ill patients. Crit Care Clin. 2007; 23(1):35-53. DOI: 10.1016/j.ccc.2006.11.005. View

Duke J, Boyd J, Randall S, Wood F . Long term mortality in a population-based cohort of adolescents, and young and middle-aged adults with burn injury in Western Australia: A 33-year study. Accid Anal Prev. 2015; 85:118-24. DOI: 10.1016/j.aap.2015.09.011. View

Ganio M, Pearson J, Schlader Z, Brothers R, Lucas R, Rivas E . Aerobic Fitness Is Disproportionately Low in Adult Burn Survivors Years After Injury. J Burn Care Res. 2013; 36(4):513-9. PMC: 3954961. DOI: 10.1097/BCR.0b013e3182a22915. View

Convertino V, Stremel R, BERNAUER E, Greenleaf J . Cardiorespiratory responses to exercise after bed rest in men and women. Acta Astronaut. 1977; 4(7-8):895-905. DOI: 10.1016/0094-5765(77)90020-0. View

Rivas E, Herndon D, Porter C, Meyer W, Suman O . Short-term metformin and exercise training effects on strength, aerobic capacity, glycemic control, and mitochondrial function in children with burn injury. Am J Physiol Endocrinol Metab. 2017; 314(3):E232-E240. PMC: 5899215. DOI: 10.1152/ajpendo.00194.2017. View

Ishizaki Y, Fukuoka H, Katsura T, Nishimura Y, Kiriyama M, Higurashi M . Psychological effects of bed rest in young healthy subjects. Acta Physiol Scand Suppl. 1994; 616:83-7. View

Porter C, Hardee J, Herndon D, Suman O . The role of exercise in the rehabilitation of patients with severe burns. Exerc Sport Sci Rev. 2014; 43(1):34-40. PMC: 4272612. DOI: 10.1249/JES.0000000000000029. View

Romero S, Moralez G, Jaffery M, Huang M, Cramer M, Romain N . Progressive exercise training improves maximal aerobic capacity in individuals with well-healed burn injuries. Am J Physiol Regul Integr Comp Physiol. 2019; 317(4):R563-R570. PMC: 6842906. DOI: 10.1152/ajpregu.00201.2019. View

10.

Shapiro Y, Epstein Y, Tsur H . Thermoregulatory responses of patients with extensive healed burns. J Appl Physiol Respir Environ Exerc Physiol. 1982; 53(4):1019-22. DOI: 10.1152/jappl.1982.53.4.1019. View

11.

Dodd H, Fletchall S, Starnes C, Jacobson K . Current Concepts Burn Rehabilitation, Part II: Long-Term Recovery. Clin Plast Surg. 2017; 44(4):713-728. DOI: 10.1016/j.cps.2017.05.013. View

12.

Lucas R, Cotter J, Morrison S, Ainslie P . The effects of ageing and passive heating on cardiorespiratory and cerebrovascular responses to orthostatic stress in humans. Exp Physiol. 2008; 93(10):1104-17. DOI: 10.1113/expphysiol.2008.042580. View

13.

Hundeshagen G, Herndon D, Clayton R, Wurzer P, McQuitty A, Jennings K . Long-term effect of critical illness after severe paediatric burn injury on cardiac function in adolescent survivors: an observational study. Lancet Child Adolesc Health. 2018; 1(4):293-301. PMC: 5865217. DOI: 10.1016/S2352-4642(17)30122-0. View

14.

Perhonen M, Franco F, Lane L, Buckey J, Blomqvist C, Zerwekh J . Cardiac atrophy after bed rest and spaceflight. J Appl Physiol (1985). 2001; 91(2):645-53. DOI: 10.1152/jappl.2001.91.2.645. View

15.

Cramer M, Huang M, Moralez G, Crandall C . Keeping older individuals cool in hot and moderately humid conditions: wetted clothing with and without an electric fan. J Appl Physiol (1985). 2020; 128(3):604-611. PMC: 7099436. DOI: 10.1152/japplphysiol.00786.2019. View

16.

Gibson O, Mee J, Tuttle J, Taylor L, W Watt P, S Maxwell N . Isothermic and fixed intensity heat acclimation methods induce similar heat adaptation following short and long-term timescales. J Therm Biol. 2015; 49-50:55-65. DOI: 10.1016/j.jtherbio.2015.02.005. View

17.

Suman O, Spies R, Celis M, Mlcak R, Herndon D . Effects of a 12-wk resistance exercise program on skeletal muscle strength in children with burn injuries. J Appl Physiol (1985). 2001; 91(3):1168-75. DOI: 10.1152/jappl.2001.91.3.1168. View

18.

Hung T, Lee Y, Huang M, Hsu C, Su Y . Increased risk of ischemic stroke in patients with burn injury: a nationwide cohort study in Taiwan. Scand J Trauma Resusc Emerg Med. 2016; 24:44. PMC: 4823901. DOI: 10.1186/s13049-016-0236-1. View

19.

Anthonissen M, Daly D, Janssens T, Van den Kerckhove E . The effects of conservative treatments on burn scars: A systematic review. Burns. 2016; 42(3):508-18. DOI: 10.1016/j.burns.2015.12.006. View

20.

Pena R, Ramirez L, Crandall C, Wolf S, Herndon D, Suman O . Effects of community-based exercise in children with severe burns: A randomized trial. Burns. 2015; 42(1):41-47. PMC: 4724475. DOI: 10.1016/j.burns.2015.07.007. View