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Effects of community-based exercise in adults with severe burns: a randomized controlled trial
Voigt CD, Foncerrada G, Pena R, Guillory AN, Andersen CR, Crandall CG, Wolf SE, Herndon DN, Suman OE
Archives of Physical Medicine and Rehabilitation 2020 Jan;101(1 Suppl):S36-S41
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the efficacy of community-based exercise programs in the rehabilitation of adult patients with burns compared with standard of care (SOC). DESIGN: Randomized controlled trial, with 2:1 randomization. SETTING: Assessments were performed in a hospital setting. The intervention was performed in a community setting. PARTICIPANTS: Adult patients (N = 45) with >= 30% total body surface area burns were randomized to participate in a community-based exercise program (n = 31) or SOC (n = 14). Patient sampling was consecutive and referred. INTERVENTIONS: The community-based exercise program consisted of 12 weeks of exercise with a community-based trainer after hospital discharge. The SOC group did not receive exercise training. MAIN OUTCOME MEASURES: Change in lean body mass index, peak torque, and peak oxygen consumption from discharge to 12 weeks postdischarge, presented as mean +/- SE. RESULTS: The community-based exercise program group showed a significant increase in peak oxygen consumption compared with SOC (community-based exercise program delta 7.723 +/- 1.522 mL/kg/min, p = 0.0006; SOC delta 2.200 +/- 1.150 mL/kg/min, p = 0.0765; community-based exercise program versus SOC, p = 0.0236). The community-based exercise program group exhibited a significant within group increase in lean body mass index (delta 1.107 +/- 0.431 kg/m2, p = 0.0003; SOC delta 1.323 +/- 0.873 kg/m2, p = 0.2808). Both groups showed significant within-group increases in peak torque (community-based exercise program delta 35.645 +/- 7.566Nm, p = 0.0003; SOC delta 34.717 +/- 11.029 Nm, p = 0.0082). No significant differences were noted between the 2 groups for lean body mass index or peak torque. CONCLUSIONS: Patients who participate in a community-based exercise program show significant improvements in cardiopulmonary fitness compared with SOC, supporting the use of a community-based exercise program as an alternative therapy to SOC in adults with severe burns.

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