Burns, Pediatric Burns, Burn Injury
Conditions
Keywords
Resistance Training, Plyometric Training, Muscle Strength, Neuromuscular Performance, Dynamic Balance, Physical Function
Brief summary
Children who experience severe burns may continue to have reduced muscle strength, power, balance, and physical function after their wounds have healed. Exercise is an important part of burn rehabilitation, but it is unclear which type of training provides the greatest improvement. This randomized study compared three exercise programs in children aged 10 to 17 years with burns affecting more than 30% of their total body surface area. Participants were assigned to traditional resistance training, plyometric training, or a program combining both approaches. Each group completed supervised exercise sessions three times per week for 8 weeks. Muscle strength, upper- and lower-body power, dynamic balance, and upper-limb stability were measured before and after the training period. The study aimed to determine which exercise approach was most effective for improving neuromuscular and functional performance during long-term pediatric burn rehabilitation.
Detailed description
Severe burn injuries can produce prolonged metabolic and muscular changes that contribute to loss of lean tissue, weakness, and reduced physical capacity in children. Although resistance exercise is commonly included in post-burn rehabilitation, the comparative effects of conventional strength training, plyometric exercise, and a combination of these approaches have not been adequately examined in this population. This assessor-blinded, three-arm randomized trial evaluated training-specific changes in pediatric burn survivors receiving long-term rehabilitation. Before the formal intervention, participants completed a 2-week supervised familiarization period focused on safe movement technique and landing mechanics. They then undertook one of three 8-week programs: traditional resistance training, plyometric training, or combined resistance and plyometric training. The programs were matched for overall exercise volume and progressed gradually in intensity and complexity. All sessions were supervised by physical therapists. Assessments were performed before training and 3 to 5 days after the final intervention session. The evaluation covered upper- and lower-body muscular power, isometric strength, handgrip performance, trunk function, dynamic balance, and upper-extremity stability. Outcome assessors remained unaware of group assignments. Post-intervention differences among the three groups were examined using analysis of covariance, with the corresponding baseline measurement included as a covariate. The study hypothesis was that all programs would improve neuromuscular performance, with the combined program producing broader improvements than either training method alone.
Interventions
Participants performed eight progressive resistance exercises targeting the upper and lower body. Sessions were held three times weekly for 8 weeks. Sessions were supervised by physical therapists and included a 10-minute warm-up and 5-minute cool-down.
OTHERPlyometric Training
Participants performed progressive upper- and lower-body plyometric exercises three times weekly for 8 weeks. Physical therapists supervised all sessions and emphasized safe takeoff and landing technique. Each session included a 10-minute warm-up and 5-minute cool-down.
OTHERCombined Resistance and Plyometric Training
Participants performed traditional resistance exercises and plyometric exercises per session, three times weekly for 8 weeks. All sessions were supervised by physical therapists and included a 10-minute warm-up and 5-minute cool-down.
Sponsors
Qassim University
Cairo 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 assigned in a 1:1:1 ratio to three parallel exercise-training groups: traditional resistance training, plyometric training, or combined resistance and plyometric training.
Eligibility
Sex/Gender
ALL
Age
10 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
* Children aged 10 to 17 years. * History of a major thermal burn affecting more than 30% of total body surface area. * Time since burn injury between 0.1 and 2 years.
Exclusion criteria
* A pre-existing or acquired neurological, musculoskeletal, cardiopulmonary, or cognitive condition that could interfere with physical performance or affect interpretation of the study outcomes. * Reconstructive surgery performed during the 6 months before the pre-intervention assessment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overhead Medicine Ball Throw | Week 0 before the intervention | Upper-body explosive power was assessed using overhead medicine ball throw. Three maximal attempts were performed with 60 seconds of rest between attempts. The longest valid throw was retained. Distance was measured in centimeters, with a greater distance indicating better performance. |
| Standing Long Jump Distance | Week 0 before the intervention | Horizontal lower-body explosive power was evaluated using a two-legged standing long jump. Three maximal attempts were completed, and the longest valid jump was retained. Distance was reported in centimeters, with a greater distance indicating better performance. |
| Countermovement Jump Height | Week 0 before the intervention | Vertical lower-body explosive power was evaluated using a countermovement jump. Three valid attempts were completed, and the greatest jump height was retained. Height was reported in centimeters, with a greater height indicating better performance. |
| Knee Flexor Isometric Strength | Week 0 before the intervention | Maximal isometric strength of the knee flexors in the dominant limb was measured with a calibrated handheld dynamometer. The result was reported in kilograms. |
| Knee Extensor Isometric Strength | Week 0 before the intervention | Maximal isometric strength of the knee extensors was measured with a calibrated handheld dynamometer. The result was reported in kilograms. |
| Elbow Flexor Isometric Strength | Week 0 before the intervention | Maximal isometric strength of the elbow flexors was measured with a calibrated handheld dynamometer. The result was reported in kilograms. |
| Elbow Extensor Isometric Strength | Week 0 before the intervention | Maximal isometric strength of the elbow extensors was measured with a calibrated handheld dynamometer. The result reported in kilograms. |
| Hand Grip Strength | Week 0 before the intervention | Maximal grip strength of the dominant hand was assessed with a calibrated hydraulic hand dynamometer. The result was reported in kilograms. |
| Trunk Lift Test | Week 0 before the intervention | Trunk-extension performance was assessed using the Trunk Lift Test. Two maximal attempts were completed, and the greater valid distance was retained. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Modified Closed Kinetic Chain Upper Extremity Stability Test | Week 0 before the intervention | Upper-extremity functional stability and dynamic control were evaluated using a modified Closed Kinetic Chain Upper Extremity Stability Test. The average number of successful touches across the three trials was retained. |
| Y-Balance Test | Week 0 before the intervention | Lower-extremity dynamic balance was evaluated using the Y-Balance Test. The composite score was calculated as: \[(anterior reach + posteromedial reach + posterolateral reach) divided by (3 × dominant-leg length)\] × 100. |
Countries
Egypt
Contacts
STUDY_DIRECTORRagab K Elnaggar, PhD
Cairo University
Outcome results
None listed