Research advances on the application of rehabilitation exercise training in pediatric burn rehabilitation
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摘要: 小儿烧伤后遗症严重影响患儿的身体功能及生活质量,以有氧运动和抗阻运动为主的运动康复训练能有效减轻其负面影响。该文综述运动康复训练对烧伤患儿心肺功能、肌肉功能以及生活质量的益处,以运动类型、运动方式、运动强度、运动频率和运动时间为主介绍最新的烧伤患儿运动康复训练处方,以期提高烧伤患儿的康复治疗水平。Abstract: The sequelae of pediatric burn seriously affect the physical function and quality of life of children with burns. Rehabilitation exercise training mainly based on aerobic and resistance exercise can effectively alleviate the negative effects. This article reviews the effects of rehabilitation exercise training on cardiopulmonary function, muscle function, and quality of life of children with burns, and introduces the latest rehabilitation exercise training prescription for children with burns based on type, mode, intensity, frequency, and time of exercise, so as to improve the level of rehabilitation treatment for children with burns.
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Key words:
- Burns /
- Child /
- Quality of life /
- Exercise rehabilitation /
- Physical function
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参考文献
(40) [1] World Health Organization Burns 2018-03-06 2022-01-16 http://www.who.int/mediacentre/factsheets/fs365/en/ World Health Organization. Burns[EB/OL]. (2018-03-06)[2022-01-16]. http://www.who.int/mediacentre/factsheets/fs365/en/.
[2] RuanJJ, XiMM, XieWG. Analysis of 12,661 pediatric burns in Wuhan institute of burns: a retrospective study of fifteen years[J]. Burns, 2021, 47(8): 1915-1921. DOI: 10.1016/j.burns.2021.02.021. [3] SpronkI, LegemateCM, PolinderS, et al. Health-related quality of life in children after burn injuries: a systematic review[J]. J Trauma Acute Care Surg, 2018, 85(6): 1110-1118. DOI: 10.1097/TA.0000000000002072. [4] ElnaggarRK,OsailanAM,AlsubaieSF,et al.Graded aerobic exercise (GAEx): an effective exercise regimen to improve cardio-respiratory fitness and physical and psychosocial functioning in children with burn sequelae of the chest[J].Burns,2022,48(2):337-344.DOI: 10.1016/j.burns.2021.05.004. [5] FloresO, TyackZ, StocktonK, et al. Exercise training for improving outcomes post-burns: a systematic review and meta-analysis[J]. Clin Rehabil, 2018, 32(6): 734-746. DOI: 10.1177/0269215517751586. [6] RivasE, TranJ, GutierrezIL, et al. Rehabilitation exercise increases physical activity levels in severely burned children while improving aerobic exercise capacity and strength[J]. J Burn Care Res, 2018, 39(6): 881-886. DOI: 10.1093/jbcr/irx045. [7] 中国老年医学学会烧创伤分会.烧伤后关节功能障碍的预防与康复治疗专家共识(2021版)[J/CD].中华损伤与修复杂志:电子版,2021,16(4):277-282.DOI: 10.3877/cma.j.issn.1673-9450.2021.04.001. [8] 中华医学会烧伤外科学分会,中国医师协会烧伤科医师分会.烧伤康复治疗指南(2013版)[J].中华烧伤杂志,2013,29(6):497-504.DOI: 10.3760/cma.j.issn.1009-2587.2013.06.001. [9] 徐庆连, 宋均辉. 小儿烧伤后瘢痕增生特点与康复治疗方案[J]. 中华烧伤杂志, 2018, 34(8): 509-512. DOI: 10.3760/cma.j.issn.1009-2587.2018.08.005. [10] 戴叶锋,岳晓洁,周一冲,等.儿童烧烫伤后瘢痕康复治疗90例分析[J/CD].中华危重症医学杂志:电子版,2019,12(5):347-348.DOI: 10.3877/cma.j.issn.1674-6880.2019.05.012. [11] SchryverE, KleinGL, HerndonDN, et al. Bone metabolism in pediatric burned patients:a review[J]. Burns, 2018, 44(8): 1863-1869. DOI: 10.1016/j.burns.2018.04.014. [12] 李梅蕊, 李殷. 烧伤儿童康复期的营养代谢与营养支持[J]. 中国康复理论与实践, 2020, 26(2): 219-222. DOI: 10.3969/j.issn.1006-9771.2020.02.014. [13] RivasE, HerndonDN, BeckKC, et al. Children with burn injury have impaired cardiac output during submaximal exercise[J]. Med Sci Sports Exerc, 2017, 49(10): 1993-2000.DOI: 10.1249/MSS.0000000000001329. [14] PalackicA,SumanOE,PorterC,et al.Rehabilitative exercise training for burn injury[J].Sports Med,2021,51(12):2469-2482.DOI: 10.1007/s40279-021-01528-4. [15] TapkingC, PoppD, HerndonDN, et al. Cardiovascular effect of varying interval training frequency in rehabilitation of severely burned children[J]. J Burn Care Res, 2019, 40(1): 34-38. DOI: 10.1093/jbcr/iry051. [16] Cambiaso-DanielJ, RivasE, CarsonJS, et al. Cardiorespiratory capacity and strength remain attenuated in children with severe burn injuries at over 3 years postburn[J]. J Pediatr, 2018, 192: 152-158. DOI: 10.1016/j.jpeds.2017.09.015. [17] de FigueiredoTB,UtsunomiyaKF,deOliveira AMRR,et al.Mobilization practices for patients with burn injury in critical care[J].Burns,2020,46(2):314-321.DOI: 10.1016/j.burns.2019.07.037. [18] HerndonDN,TompkinsRG.Support of the metabolic response to burn injury[J].Lancet,2004,363(9424):1895-1902.DOI: 10.1016/S0140-6736(04)16360-5. [19] Cambiaso-DanielJ, MalagarisI, RivasE, et al. Body composition changes in severely burned children during ICU hospitalization[J]. Pediatr Crit Care Med, 2017, 18(12): e598-e605. DOI: 10.1097/PCC.0000000000001347. [20] AkkermanM,MoutonLJ,de GrootS,et al.Predictability of exercise capacity following pediatric burns: a preliminary investigation[J].Disabil Rehabil,2021,43(5):703-712.DOI: 10.1080/09638288.2019.1641846. [21] AllojuSM,HerndonDN,McEntireSJ,et al.Assessment of muscle function in severely burned children[J].Burns,2008,34(4):452-459.DOI: 10.1016/j.burns.2007.10.006. [22] ClaytonRP, WurzerP, AndersenCR, et al. Effects of different duration exercise programs in children with severe burns[J]. Burns, 2017, 43(4): 796-803. DOI: 10.1016/j.burns.2016.11.004. [23] KingICC.Body image in paediatric burns: a review[J/OL].Burns Trauma,2018,6:12[2022-01-16]. https://pubmed.ncbi.nlm.nih.gov/29744373/.DOI: 10.1186/s41038-018-0114-3. [24] DukeJM, RandallSM, VetrichevvelTP, et al. Long-term mental health outcomes after unintentional burns sustained during childhood: a retrospective cohort study[J/OL]. Burns Trauma, 2018, 6: 32[2022-01-16]. https://pubmed.ncbi.nlm.nih.gov/30460320/.DOI: 10.1186/s41038-018-0134-z. [25] GittingsPM, GrisbrookTL, EdgarDW, et al. Resistance training for rehabilitation after burn injury: a systematic literature review & meta-analysis[J]. Burns, 2018, 44(4): 731-751. DOI: 10.1016/j.burns.2017.08.009. [26] RosenbergM, CelisMM, MeyerW, et al. Effects of a hospital based Wellness and Exercise program on quality of life of children with severe burns[J]. Burns, 2013, 39(4): 599-609. DOI: 10.1016/j.burns.2012.08.019. [27] PeñaR, SumanOE, RosenbergM,et al. One-year comparison of a community-based exercise program versus a day hospital-based exercise program on quality of life and mental health in severely burned children[J]. Arch Phys Med Rehabil, 2020, 101(1 Suppl): S26-35. DOI: 10.1016/j.apmr.2017.10.023. [28] TanJL, ChenJ, ZhouJY, et al. Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care unit in China: a descriptive analysis[J/OL]. Burns Trauma, 2019, 7: 17[2022-01-16]. https://pubmed.ncbi.nlm.nih.gov/31139664/.DOI: 10.1186/s41038-019-0151-6. [29] RomeroSA,MoralezG,JafferyMF,et al.Progressive exercise training improves maximal aerobic capacity in individuals with well-healed burn injuries[J].Am J Physiol Regul Integr Comp Physiol,2019,317(4):R563-R570.DOI: 10.1152/ajpregu.00201.2019. [30] RivasE, HerndonDN, Cambiaso-DanielJ, et al. Quantification of an exercise rehabilitation program for severely burned children: the standard of care at Shriners Hospitals for Children®-Galveston[J]. J Burn Care Res, 2018, 39(6): 889-896. DOI: 10.1093/jbcr/iry001. [31] 杨莎, 邱林. 抗阻训练对烧伤患儿康复效果影响的研究进展[J]. 中华烧伤杂志, 2021, 37(9): 895-899. DOI: 10.3760/cma.j.cn501120-20200717-00349. [32] ConnAS, HallMS, QuinnK, et al. An examination of a yoga intervention with pediatric burn survivors[J]. J Burn Care Res, 2017, 38(1): e337-e342. DOI: 10.1097/BCR.0000000000000385. [33] RivasE, HerndonDN, PorterC, et al. Short-term metformin and exercise training effects on strength, aerobic capacity, glycemic control, and mitochondrial function in children with burn injury[J]. Am J Physiol Endocrinol Metab, 2018, 314(3): E232-E240. DOI: 10.1152/ajpendo.00194.2017. [34] ChaoT, PorterC, HerndonDN, et al. Propranolol and oxandrolone therapy accelerated muscle recovery in burned children[J]. Med Sci Sports Exerc, 2018, 50(3): 427-435. DOI: 10.1249/MSS.0000000000001459. [35] 美国运动医学学会. ACSM运动测试与运动处方指南(第十版)[M]. 王正珍,译.北京: 北京体育大学出版社, 2018. [36] HardeeJP, PorterC, SidossisLS, et al. Early rehabilitative exercise training in the recovery from pediatric burn[J]. Med Sci Sports Exerc, 2014, 46(9): 1710-1716. DOI: 10.1249/MSS.0000000000000296. [37] AdamsMA,JohnsonWD,Tudor-LockeC.Steps/day translation of the moderate-to-vigorous physical activity guideline for children and adolescents[J].Int J Behav Nutr Phys Act,2013,10:49.DOI: 10.1186/1479-5868-10-49. [38] 成路, 赵香莲, 任玉蓉,等. 基于微信平台的延续性治疗指导对儿童烧伤患者瘢痕增生的影响[J]. 西南军医, 2021, 23(1): 54-56. DOI: 10.3969/j.issn.1672-7193.2021.01.016. [39] 段建兴, 刘文军, 张高飞, 等. 体感游戏在烧伤康复中的应用研究进展[J]. 护理研究, 2021, 35(6): 1037-1040. DOI: 10.12102/j.issn.1009-6493.2021.06.016. [40] KamelFAH, BashaMA. Effects of virtual reality and task-oriented training on hand function and activity performance in pediatric hand burns: a randomized controlled trial[J]. Arch Phys Med Rehabil, 2021, 102(6): 1059-1066. DOI: 10.1016/j.apmr.2021.01.087. -
表1 烧伤患儿运动康复训练处方
维度 运动类型 有氧运动 抗阻运动 运动方式 跑步机训练、骑功率自行车、椭圆机训练、划船机训练、瑜伽、快速步行、体育运动(如踢足球、打篮球等) 先从大肌肉训练开始,再进行小肌肉的训练,可使用不同的阻力机、力量训练器或阻力带 运动强度 储备心率的60%~75%,>80%的最大心率,VO 2peak的70%~85%,自觉疲劳程度量表评级的6~8级 运动第1~2周:50%~60% 3RM,重复12~15次;运动第3~6周:70%~75% 3RM,重复8~10次;运动第7~12周:75%~85% 3RM,重复8~12次 运动频率 每周3~5 d 每周2~3 d;如每天进行,可上半身和下半身交替锻炼 运动时间 实际运动时长20~40 min 完成10项基本阻力练习(上半身和下半身各5项)+1~3项核心训练所需时间 运动总量 每日运动步数5 000~10 000步,持续12周;每周>150 min的有氧运动(从每天10 min开始逐渐增加有氧训练时间,直到12周时达到每天60 min) 每周上半身容量负荷为130 kg、下半身容量负荷为280 kg 注:储备心率指人体在劳动或运动时心率可能增加的潜在能力,为实测最大心率(在实验室测定的)与静息心率之差,计算公式为(最大心率-静息心率)×强度百分比+静息心率;最大心率指进行运动负荷时,随着运动量的增加,耗氧量和心率也增加,在最大负荷强度时,耗氧量和心率不能继续增加时心率达到的最高水平;VO 2peak为最大摄氧量,指在人体进行最大强度的运动时,各器官、系统机能达到最高,机体所能摄入的氧气含量;RM为可重复的最大重量,3RM表示可重复3次的最大重量;容量负荷为阻力运动的运动量,计算公式为重复次数×组数×重量
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