The role of early exercise in the management of muscle wasting following acute burn injury
Burn injury is a complex form of trauma that, when severe enough, causes a sustained stress response that impacts all organ systems. Long-lasting derangements in muscle metabolism associated with the stress response lead to the loss of skeletal muscle mass and function. Postburn muscle wasting in turn is associated with considerable short-term and long-term morbidity. Despite its impact, postburn muscle wasting is often regarded as an inevitable burn-related symptom that is often left to develop unrestrained during the early phase of burn recovery – a phase during which it could theoretically be best countered by targeted interventions. Resistance and aerobic training during burn centre stay, collectively referred to as ‘early exercise training’ in this dissertation, has been used successfully in other disease phenotypes to counteract muscle wasting. However, in burn care, many uncertainties persist over the role of early exercise training in the management of postburn muscle wasting. Reservations over its safety, feasibility, and efficacy in the adult burn population have hampered its integration into standard inpatient burn care. Thus, the overarching aim of this doctoral project was to better understand the role of early exercise training in the inpatient management of burn-induced muscle wasting. This dissertation presents research that was carried out to (1) survey the current rehabilitation practice of burn patients, (2) study the clinical utility of ultrasound as a tool to measure muscle wasting, and lastly (3) investigated the feasibility and efficacy of early exercise training to address muscle wasting in both minor and major burns. The findings accumulated by all the studies in this doctoral dissertation, combine to advocate that the clinical benefits of targeting postburn muscle wasting by early exercise training outweigh its costs. We show this by demonstrating that muscle wasting is an important outcome that can be captured by ultrasound, and by establishing the safety, feasibility, and efficacy of early exercise with respect to changes in muscle size and strength.
Antwerp : University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy , 2023
VIII, 174 p.
Supervisor: van Daele, Ulrike [Supervisor]
Supervisor: van Breda, Eric [Supervisor]
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Pathophysiological mechanisms and exercise counter measures of hypermetabolism and muscle wasting in severe burns
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Publications with a UAntwerp address
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Creation 05.12.2023
Last edited 09.12.2023
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