Effects of mobility training on severe burn patients in the BICU: A retrospective cohort study

Deng, Huan; Chen, Jian; Li, Frank; Li‐Tsang, Cecilia W. P.; Liu, Qiushi; Ma, Xinbin; Ao, Ming; Chen, Nan; Zhou, Yaqin; Zhong, Xiaoyun; Chen, Zhiyu; Cao, Lei; He, Guiyang; Wu, Jun

doi:10.1016/j.burns.2016.07.029

Cited by 39 publications

(30 citation statements)

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“…Prolonged immobilization results in loss of body nitrogen and a decrease in skeletal muscle protein synthesis [ 58 , 59 ]. In contrast, assisting patients to move and exercise during in-hospital care may ameliorate the detrimental effects of bed rest on muscle tissue [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

The response of muscle progenitor cells to cutaneous thermal injury

et al. 2017

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BackgroundSevere burn results in a systemic response that leads to significant muscle wasting. It is believed that this rapid loss in muscle mass occurs due to increased protein degradation combined with reduced protein synthesis. Alterations in the microenvironment of muscle progenitor cells may partially account for this pathology. The aim of this study was to ascertain the response of muscle progenitor cells following thermal injury in mice and to enlighten the cellular cascades that contribute to the muscle wasting.MethodsC57BL/6 mice received a 20% total body surface area (TBSA) thermal injury. Gastrocnemius muscle was harvested at days 2, 7, and 14 following injury for protein and histological analysis.ResultsWe observed a decrease in myofiber cross-sectional area at 2 days post-burn. This muscle atrophy was compensated for by an increase in myofiber cross-sectional area at 7 and 14 days post-burn. Myeloperoxidase (MPO)-positive cells (neutrophils) increased significantly at 2 days. Moreover, through Western blot analysis of two key mediators of the proteolytic pathway, we show there is an increase in Murf1 and NF-κB 2 days post-burn. MPO-positive cells were also positive for NF-κB, suggesting that neutrophils attain NF-κB activity in the muscle. Unlike inflammatory and proteolytic pathways, the number of Pax7-positive muscle progenitor cells decreased significantly 2 days post-burn. This was followed by a recovery in the number of Pax7-positive cells at 7 and 14 days, suggesting proliferation of muscle progenitors that accompanied regrowth.ConclusionOur data show a biphasic response in the muscles of mice exposed to burn injury, with phenotypic characteristics of muscle atrophy at 2 days while compensation was observed later with a change in Pax7-positive muscle progenitor cells. Targeting muscle progenitors may be of therapeutic benefit in muscle wasting observed after burn injury.Electronic supplementary materialThe online version of this article (doi:10.1186/s13287-017-0686-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The response of muscle progenitor cells to cutaneous thermal injury

et al. 2017

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“…From then on, the methods of rehabilitation have gradually become diversified and professional. The provided rehabilitation includes not only anti-contracture positioning but also passive training (i.e., positioning, splinting, and passive range of motility (ROM) exercises) and mobility training (i.e., active ROM exercises, transfer training, and tilt table training) [65]. To raise the doctors’ awareness of rehabilitation and promote the development of rehabilitation in China, experts in our institute, who are the key members of the Chinese Burn Association and the Chinese Association of Burn Surgeons, organized the guidelines for Chinese burn rehabilitation in 2015 [66].…”

Section: Reviewmentioning

confidence: 99%

The progress of Chinese burn medicine from the Third Military Medical University—in memory of its pioneer, Professor Li Ao

Zhou

Peng

et al. 2017

Burns &Amp; Trauma

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Professor Li Ao was one of the founders of Chinese burn medicine and one of the most renowned doctors and researchers of burns in China. He established one of the Chinese earliest special departments for burns at Third Military Medical University (TMMU) in 1958. To memorialize Professor Li Ao on his 100th birthday in 2017 and introduce our extensive experience, it is our honor to briefly review the development and achievement of the Chinese burn medicine from TMMU. The epidemiology and outcomes of admitted burn patients since 1958 were reviewed. Furthermore, main achievements of basic and clinical research for the past roughly 60 years were presented. These achievements mainly included the Chinese Rule of Nine, fluid resuscitation protocol, experience in inhalation injury, wound treatment strategies, prevention and treatment of burn infections, nutrition therapy, organ support therapies, and rehabilitation. The progress shaped and enriched modern Chinese burn medicine and promoted the development of world burn medicine.

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“…Usually, traditional rehabilitation interventions in mainland China are provided after most wound areas are healed. In contrast, early rehabilitation in burn patients showed improvement in joint ROM and a shorter BICU LOS and in the hospital [27–29]. According to the analysis in this study, we found that when early rehabilitation was performed within 7 days post-injury, severe burn patients could have fewer contractures of decreased severity.…”

Section: Discussionmentioning

confidence: 78%

Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care unit in China: a descriptive analysis

et al. 2019

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Background Joint contracture is the major clinical complication in burn patients, especially, the severe burn patients. This study aimed to investigate the number and severity of joint contractures in patients with burns affecting greater than or equal to 50% of the total body surface area (TBSA) undergoing early rehabilitation in a burn intensive care unit (BICU). Methods We analyzed burn patients with burns affecting greater than or equal to 50% of the TBSA admitted to a BICU who received early rehabilitation within 7 days post-injury from January 2011 to December 2015. Demographic and medical information was collected. The range of motion (ROM) of different joints was measured 1 month post-admission. Spearman’s correlation coefficient and logistic regression analysis was used to determine predictors of the presence and severity of contractures. Result The average affected TBSA of the included burn patients was 67.4%, and the average length of stay in the BICU was 46.2 ± 28.8 days. One hundred and one of 108 burn patients (93.5%) developed at least one joint contracture. The ROM in 67.9% of the affected joints was mildly limited. The majority of contractures in severe burn patients were mild (37.7%) or moderate (33.2%). The wrist was the most commonly affected joint (18.2%), followed by the shoulder, ankle, hip, knee, and elbow. A predictor of the presence of contractures was the length of hospital stay (p = 0.049). The severe contracture was related to the area of full-thickness burns, the strict bed rest time, and the duration of rehabilitation in BICU. The length of rehabilitation stay (days) in patients with moderate contracture is 54.5% longer than that in severe contracture (p = 0.024) Conclusion During the long stay in BICU, the length of rehabilitation stay in a BICU could decrease the severity of contractures from severe to moderate in the patients with equal to 50% of the TBSA. Hence, this research reveals the important role of early rehabilitation interventions in severe burn patients.

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Effects of mobility training on severe burn patients in the BICU: A retrospective cohort study

Cited by 39 publications

References 34 publications

The response of muscle progenitor cells to cutaneous thermal injury

The response of muscle progenitor cells to cutaneous thermal injury

The progress of Chinese burn medicine from the Third Military Medical University—in memory of its pioneer, Professor Li Ao

Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care unit in China: a descriptive analysis

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