Effect of exercise training on pulmonary function in children with thermal injury

Severe thermal injury in children results in a decrease in pulmonary function (PF) which lasts well into convalescence. Exercise has been used successfully to improve PF in other populations exhibiting a compromised PF such as in chronic obstructive pulmonary disease. Yet, whether exercise training will induce improvements in PF in burned children is presently unknown. We therefore evaluated if an exercise program improved PF in severely burned children (BC). Twenty healthy controls, nonburn children (NB) age 7 to <18 and 31 severely burned children; ages 7 to <18 years old, with greater than 40% of total body surface area burned were enrolled in the study. Burned children were randomized into two groups. One to participate in a 12-week in-hospital physical rehabilitation program supplemented with an exercise-training program (REX, n = 17) and the other nonexercising group (R, n = 14) to participate in a 12-week, home-based physical rehabilitation program without exercise. Pulmonary function tests were performed for all groups at baseline, but only the REX and R groups were tested after 12 weeks of either exercise or no exercise. Baseline PF for the NB group was normal and no differences in PF were found between the R vs REX groups. However, PF was decreased in BC compared to NB children. There was a significant improvement in PF in the REX group. In contrast, PF in the R group remained relatively unchanged. Severely burned children improve PF as a result of an exercise program and such should be a fundamental component of a multidisciplinary outpatient treatment program for victims of thermal injury.