Pediatric Burns, Burn Injury, Post-Burn Rehabilitation, Rehabilitation, Muscle Weakness, Functional Limitation
Conditions
Keywords
Pediatric burns, Rehabilitation, Plyometric training, Muscle strength, Muscle power, Functional performance
Brief summary
Pediatric burn survivors may experience persistent deficits in lower-limb strength, explosive power, and functional performance after hospital discharge. This randomized controlled trial evaluated whether a 12-week supervised plyometric training program improves lower-extremity muscle strength, power, and functional capacity compared with a standard exercise program in children and adolescents with severe burn injuries.
Detailed description
This two-arm, parallel-group, single-blind randomized controlled trial included 62 pediatric burn survivors aged 10-18 years with severe burns involving ≥30% total body surface area and lower-limb involvement. Participants were recruited 6-12 months after hospital discharge and randomly allocated in a 1:1 ratio to either plyometric training or standard exercise. Both groups received supervised exercise twice weekly for 12 weeks. The experimental group completed progressive plyometric exercises designed to enhance lower-extremity explosive power and dynamic functional mobility. The control group received standard post-discharge rehabilitation focused on flexibility, aerobic conditioning, mobility, and basic strengthening. Outcomes were assessed at baseline and immediately after the 12-week intervention by blinded assessors.
Interventions
OTHERPlyometric Training
Participants in the plyometric training group will receive a 12-week supervised program, with each session lasting 45 minutes and designed to improve lower-extremity explosive power and dynamic functional mobility. Sessions will include a 5-minute dynamic warm-up, 35 minutes of progressive plyometric exercises targeting vertical and horizontal force production, and a 5-minute cool-down. Training will be individually supervised with safety measures including shock-absorbing flooring, cushioned footwear, technique monitoring, and standardized rest intervals.
Participants in the control group will receive a 12-week supervised program, with each session lasting 45 minutes post-discharge burn rehabilitation program focusing on mobility, flexibility, aerobic conditioning, and basic lower-limb strengthening. Sessions will include warm-up, stretching, moderate-intensity aerobic exercise at 50-70% of age-predicted maximum heart rate, strengthening exercises, and cool-down, with progression based on participant tolerance.
Sponsors
Qassim University
Prince Sattam Bin Abdulaziz University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Participants were randomized 1:1 to plyometric training or standard exercise for 12 weeks. Outcome assessors were blinded to group allocation.
Eligibility
Sex/Gender
ALL
Age
10 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Children and adolescents aged 10-18 years at the time of enrolment. * History of severe burn injury involving ≥30% total body surface area (TBSA), with lower-extremity involvement. * Between 6 and 12 months post-hospital discharge. * Ability to understand study instructions and safely perform the prescribed exercise program.
Exclusion criteria
* Pre-existing neurological or musculoskeletal disorders that may affect lower-limb function or study outcomes. * Severe lower-limb joint contracture limiting functional movement. * Cognitive impairment preventing understanding of instructions or reliable participation. * Participation in another structured exercise, rehabilitation, or physical therapy program outside the study protocol during the trial period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lower-Limb Muscle Strength | pre-intervention (Week 0) | Quadriceps and hamstring strength will be assessed using an isokinetic dynamometer. After standardized positioning, stabilization, warm-up, and familiarization, participants will perform five maximal reciprocal knee extension/flexion repetitions. The highest peak torque value (Nm) for hamstrings and quadriceps will be recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Figure-of-8 Walk/Run Test Time | pre-intervention (Week 0) | Dynamic balance, agility, and coordination will be assessed using the Figure-of-8 Walk/Run Test. Participants will complete two full loops around two cones placed 5 meters apart as quickly as possible. Two trials will be performed, and the fastest completion time will be recorded in seconds. |
| Vertical Jump Height | pre-intervention (Week 0) | Vertical Jump Test: Lower-limb explosive power will be assessed using a vertical jump performed on a force plate. Participants will jump maximally with hands on hips to minimize arm contribution, completing three trials with 60 seconds of rest between trials. The highest jump height will be recorded in centimeters. |
| Broad Jump Distance | pre-intervention (Week 0) | Horizontal lower-limb power and dynamic leg strength will be assessed using the broad jump test. Participants will perform three maximal two-footed forward jumps from a marked starting line, with 60 seconds of rest between trials. The longest distance, measured from the starting line to the rearmost landing point, will be recorded in centimeters. |
| Reactive Strength Index | pre-intervention (Week 0) | Reactive strength will be assessed using a drop jump from a 30-cm box onto a force plate. Three trials will be performed with 60 seconds of rest, and the highest reactive strength index value, calculated as jump height divided by ground contact time, will be recorded. |
| Lower Extremity Functional Scale Score | pre-intervention (Week 0) | Lower-limb functional ability will be assessed using the 20-item Lower Extremity Functional Scale, which evaluates perceived difficulty in activities such as walking, running, stair climbing, and squatting. Each item is scored from 0 to 4, with a total score ranging from 0 to 80. Higher scores indicate better functional capacity. |
| Six-Minute Walk Test Distance | pre-intervention (Week 0) | Functional exercise capacity will be assessed using the Six-Minute Walk Test performed along a 30-meter indoor corridor according to standardized guidelines. Participants will be instructed to walk as far as possible, without running, within six minutes, and the total distance covered will be recorded in meters. |
| 4×10-Meter Shuttle Run Time | pre-intervention (Week 0) | Agility and speed will be assessed using the 4×10-meter shuttle run test. Participants will run back and forth between two cones placed 10 meters apart, completing four 10-meter segments for a total distance of 40 meters. Two trials will be performed, and the fastest completion time will be recorded in seconds. |
| Timed Up and Down Stairs Performance | pre-intervention (Week 0) | Lower-limb power, agility, and dynamic balance will be assessed using the Timed Up and Down Stairs test. Participants will ascend and descend 10 standard stairs as quickly and safely as possible, with two trials performed and the fastest time recorded in seconds. |
Countries
Saudi Arabia
Contacts
STUDY_DIRECTORMaged A Basha, PhD
Qassim University
Outcome results
None listed