Effect of In-Patient Exercise Training on Length of Hospitalization in Burned Patients
NCT ID: NCT02739464
Last Updated: 2020-11-06
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
77 participants
Study Classification
INTERVENTIONAL
Study Start Date
2014-09-15
Study Completion Date
2020-09-25
Brief Summary
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This study will measure efficacy of early in-patient exercise as an adjunct to current Standard of Care (SOC) for 96 patients in a multi-centre trial. The secondary purpose is to assess the efficacy of a personalized, structured, and quantifiable exercise program (MP10) carried out soon after admission until hospital discharge (including during the BICU stay and time on ventilation).
Detailed Description
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After severe burns (≥ 30% total body surface area \[TBSA\] burns, patients enter a persistent and extensive hypermetabolic and catabolic state. Unfortunately, burn-induced muscle catabolism is exacerbated by the prolonged bed rest and inactivity that accompanies hospitalization, leading to further loss of muscle mass and extreme weakness. The persistence of weakness, fatigue, and muscle catabolism from prolonged bed rest and inactivity during the acute care stage ultimately delays rehabilitation and return to normal physical activities. Studies conducted in non-burn patients have shown that, aside from decreasing muscle mass, prolonged bed rest has a host of other negative physiological consequences.
The primary purpose of this randomized, controlled, multicenter study is being conducted to determine the efficacy of early in-patient exercise, when used as an adjunct to standard of care (SOC), in improving recovery of adults from burns. The secondary purpose is to assess the efficacy of a personalized, structured, and quantifiable exercise program (hereafter referred to as MP10) carried out soon after admission until hospital discharge (including during the BICU stay and time on ventilation). This objective will be met through a multicenter trial in children and adults (7 - 60 years) with ≥30% TBSA burns. Outcome variables will include BICU days, ventilator days, hospital days, peak treadmill time, and lean body mass and psychosocial function (See Section 8 for details).
Methods: Ninety-six subjects will be recruited from four sites (24 subjects each) for this study and all genders and ethnicities will be invited. All subject will have TBSA \> 30% and be ages 7-60 years of age. The first objective of this multicenter study will be to characterize the SOC related to physical/occupational therapy of inpatients at four U.S. burn centers, through 25 question surveys. The second portion of the project will involve exercise research. The objective is to assess the efficacy of MP10, in conjunction with existing SOC, in reducing debilitation among discharged burn patients. This will be initiated following surgeon's prescription, roughly 3-5 days following the first surgery after admission.
Ergonomic exercise training for the in-patient subjects will be conducted using Leg and Arm Ergometer equipment, and the training period will be daily for 10 minutes. The duration will be the duration the patient is held in the Burn Intensive Care Unit (BICU). Testing will include the following: Lean mass (assessed via dual energy x-ray absorptiometry (DEXA), Cardiopulmonary and muscle endurance test (peak VO2 on treadmill test), and weekly 6 minute walk test.
Data Analysis: A repeated measure ANOVA will be calculated using lean body mass and peak VO2 as dependent variables with the independent variables of TBA%, duration of hospital stay (and days of ergonomic exercise), ventilator days, and demographics. The purpose of this study is to measure efficacy of exercise training while in BICU for thermal injury patients.
The primary purpose of this randomized, controlled, multicenter study is being conducted to determine the efficacy of early in-patient exercise, when used as an adjunct to standard of care (SOC), in improving recovery of adults from burns. The secondary purpose is to assess the efficacy of a personalized, structured, and quantifiable exercise program (hereafter referred to as MP10) carried out soon after admission until hospital discharge (including during the BICU stay and time on ventilation). This objective will be met through a multicenter trial in children and adults (7 - 60 years) with ≥30% TBSA burns. Outcome variables will include BICU days, ventilator days, hospital days, peak treadmill time, and lean body mass and psychosocial function (See Section 8 for details).
Methods: Ninety-six subjects will be recruited from four sites (24 subjects each) for this study and all genders and ethnicities will be invited. All subject will have TBSA \> 30% and be ages 7-60 years of age. The first objective of this multicenter study will be to characterize the SOC related to physical/occupational therapy of inpatients at four U.S. burn centers, through 25 question surveys. The second portion of the project will involve exercise research. The objective is to assess the efficacy of MP10, in conjunction with existing SOC, in reducing debilitation among discharged burn patients. This will be initiated following surgeon's prescription, roughly 3-5 days following the first surgery after admission.
Ergonomic exercise training for the in-patient subjects will be conducted using Leg and Arm Ergometer equipment, and the training period will be daily for 10 minutes. The duration will be the duration the patient is held in the Burn Intensive Care Unit (BICU). Testing will include the following: Lean mass (assessed via dual energy x-ray absorptiometry (DEXA), Cardiopulmonary and muscle endurance test (peak VO2 on treadmill test), and weekly 6 minute walk test.
Data Analysis: A repeated measure ANOVA will be calculated using lean body mass and peak VO2 as dependent variables with the independent variables of TBA%, duration of hospital stay (and days of ergonomic exercise), ventilator days, and demographics. The purpose of this study is to measure efficacy of exercise training while in BICU for thermal injury patients.
Conditions
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Muscle Weakness
Late Effect of Burn
Muscle; Fatigue, Heart
Burn Rehabilitation
Keywords
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Burn
Exercise
Ergometer
MP-10
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
OTHER
Blinding Strategy
NONE
Study Groups
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Exercise + SOC PT/OT
SOC treatment plus a personalized, structured, and quantifiable exercise program (MP10) carried out soon after admission until hospital discharge (including during the BICU stay and time on ventilation.
Group Type
EXPERIMENTAL
Exercise + SOC PT/OT
Intervention Type
OTHER
SOC PT/OT
Only SOC for treating in-patient burn subjects
Group Type
ACTIVE_COMPARATOR
SOC PT/OT
Intervention Type
OTHER
Interventions
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Exercise + SOC PT/OT
Intervention Type
OTHER
SOC PT/OT
Intervention Type
OTHER
Eligibility Criteria
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Inclusion Criteria
1. Male and female subjects ≥7 to 60 years of age
2. \>30% TBSA burned, as estimated by the physician in charge
3. No evidence of organ failure
2. \>30% TBSA burned, as estimated by the physician in charge
3. No evidence of organ failure
Exclusion Criteria
1. Active Tuberculosis- based on clinical symptoms and/or abnormal chest x-ray in the upper lobe.
2. Electrical burns
3. Mental retardation or autism or any other mental disorder that makes it impossible to participate in an exercise program
4. Pregnancy
2. Electrical burns
3. Mental retardation or autism or any other mental disorder that makes it impossible to participate in an exercise program
4. Pregnancy
Minimum Eligible Age
7 Years
Maximum Eligible Age
60 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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United States Army Institute of Surgical Research
FED
Sponsor Role
collaborator
University of Texas Southwestern Medical Center
OTHER
Sponsor Role
collaborator
California State University, Sacramento
OTHER
Sponsor Role
collaborator
The University of Texas Medical Branch, Galveston
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Oscar Suman
Role: PRINCIPAL_INVESTIGATOR
University of Texas Medical Branch/Shriners Hospital for Children
Locations
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University of California-Davis/Shriners Hospitals for Children-Sacramento
Davis, California, United States
Site Status
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Site Status
University of Texas Medical Branch/Shriners Hospitals for Children-Galveston (lead site)
Galveston, Texas, United States
Site Status
United States Army Institute of Surgical Research
San Antonio, Texas, United States
Site Status
Countries
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United States
References
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Bloomfield SA. Changes in musculoskeletal structure and function with prolonged bed rest. Med Sci Sports Exerc. 1997 Feb;29(2):197-206. doi: 10.1097/00005768-199702000-00006.
Reference Type
BACKGROUND
Bartone PT. Test-retest reliability of the dispositional resilience scale-15, a brief hardiness scale. Psychol Rep. 2007 Dec;101(3 Pt 1):943-4. doi: 10.2466/pr0.101.3.943-944.
Reference Type
BACKGROUND
Kildal M, Andersson G, Fugl-Meyer AR, Lannerstam K, Gerdin B. Development of a brief version of the Burn Specific Health Scale (BSHS-B). J Trauma. 2001 Oct;51(4):740-6. doi: 10.1097/00005373-200110000-00020.
Reference Type
BACKGROUND
Hart DW, Wolf SE, Mlcak R, Chinkes DL, Ramzy PI, Obeng MK, Ferrando AA, Wolfe RR, Herndon DN. Persistence of muscle catabolism after severe burn. Surgery. 2000 Aug;128(2):312-9. doi: 10.1067/msy.2000.108059.
Reference Type
RESULT
Ferrando AA, Lane HW, Stuart CA, Davis-Street J, Wolfe RR. Prolonged bed rest decreases skeletal muscle and whole body protein synthesis. Am J Physiol. 1996 Apr;270(4 Pt 1):E627-33. doi: 10.1152/ajpendo.1996.270.4.E627.
Reference Type
RESULT
Ferrando AA, Paddon-Jones D, Wolfe RR. Bed rest and myopathies. Curr Opin Clin Nutr Metab Care. 2006 Jul;9(4):410-5. doi: 10.1097/01.mco.0000232901.59168.e9.
Reference Type
RESULT
Bassey EJ, Bennett T, Birmingham AT, Fentem PH, Fitton D, Goldsmith R. Effects of surgical operation and bed rest on cardiovascular responses to exercise in hospital patients. Cardiovasc Res. 1973 Sep;7(5):588-92. doi: 10.1093/cvr/7.5.588. No abstract available.
Reference Type
RESULT
Convertino V, Hung J, Goldwater D, DeBusk RF. Cardiovascular responses to exercise in middle-aged men after 10 days of bedrest. Circulation. 1982 Jan;65(1):134-40. doi: 10.1161/01.cir.65.1.134.
Reference Type
RESULT
Convertino VA, Bisson R, Bates R, Goldwater D, Sandler H. Effects of antiorthostatic bedrest on the cardiorespiratory responses to exercise. Aviat Space Environ Med. 1981 Apr;52(4):251-5. No abstract available.
Reference Type
RESULT
Greenleaf JE, Wade CE, Leftheriotis G. Orthostatic responses following 30-day bed rest deconditioning with isotonic and isokinetic exercise training. Aviat Space Environ Med. 1989 Jun;60(6):537-42.
Reference Type
RESULT
Hung J, Goldwater D, Convertino VA, McKillop JH, Goris ML, DeBusk RF. Mechanisms for decreased exercise capacity after bed rest in normal middle-aged men. Am J Cardiol. 1983 Jan 15;51(2):344-8. doi: 10.1016/s0002-9149(83)80063-0.
Reference Type
RESULT
Miller PB, Johnson RL, Lamb LE. Effects of moderate physical exercise during four weeks of bed rest on circulatory functions in man. Aerosp Med. 1965 Nov;36(11):1077-82. No abstract available.
Reference Type
RESULT
Convertino V, Hoffler GW. Cardiovascular physiology. Effects of microgravity. J Fla Med Assoc. 1992 Aug;79(8):517-24.
Reference Type
RESULT
Convertino VA. Effects of exercise and inactivity on intravascular volume and cardiovascular control mechanisms. Acta Astronaut. 1992 Jul;27:123-9. doi: 10.1016/0094-5765(92)90188-o.
Reference Type
RESULT
Dudley GA, Gollnick PD, Convertino VA, Buchanan P. Changes of muscle function and size with bedrest. Physiologist. 1989 Feb;32(1 Suppl):S65-6. No abstract available.
Reference Type
RESULT
Greenleaf JE, Van Beaumont W, Convertino VA, Starr JC. Handgrip and general muscular strength and endurance during prolonged bedrest with isometric and isotonic leg exercise training. Aviat Space Environ Med. 1983 Aug;54(8):696-700. No abstract available.
Reference Type
RESULT
LeBlanc A, Gogia P, Schneider V, Krebs J, Schonfeld E, Evans H. Calf muscle area and strength changes after five weeks of horizontal bed rest. Am J Sports Med. 1988 Nov-Dec;16(6):624-9. doi: 10.1177/036354658801600612.
Reference Type
RESULT
Bienso RS, Ringholm S, Kiilerich K, Aachmann-Andersen NJ, Krogh-Madsen R, Guerra B, Plomgaard P, van Hall G, Treebak JT, Saltin B, Lundby C, Calbet JA, Pilegaard H, Wojtaszewski JF. GLUT4 and glycogen synthase are key players in bed rest-induced insulin resistance. Diabetes. 2012 May;61(5):1090-9. doi: 10.2337/db11-0884. Epub 2012 Mar 8.
Reference Type
RESULT
Stremel RW, Convertino VA, Bernauer EM, Greenleaf JE. Cardiorespiratory deconditioning with static and dynamic leg exercise during bed rest. J Appl Physiol. 1976 Dec;41(6):905-9. doi: 10.1152/jappl.1976.41.6.905.
Reference Type
RESULT
Crandall CG, Shibasaki M, Wilson TE, Cui J, Levine BD. Prolonged head-down tilt exposure reduces maximal cutaneous vasodilator and sweating capacity in humans. J Appl Physiol (1985). 2003 Jun;94(6):2330-6. doi: 10.1152/japplphysiol.00790.2002. Epub 2003 Feb 21.
Reference Type
RESULT
Greenleaf JE, Reese RD. Exercise thermoregulation after 14 days of bed rest. J Appl Physiol Respir Environ Exerc Physiol. 1980 Jan;48(1):72-8. doi: 10.1152/jappl.1980.48.1.72.
Reference Type
RESULT
Levine DS, Greenleaf JE. Immunosuppression during spaceflight deconditioning. Aviat Space Environ Med. 1998 Feb;69(2):172-7.
Reference Type
RESULT
Tipton CM, Greenleaf JE, Jackson CG. Neuroendocrine and immune system responses with spaceflights. Med Sci Sports Exerc. 1996 Aug;28(8):988-98. doi: 10.1097/00005768-199608000-00009.
Reference Type
RESULT
DeRoshia CW, Greenleaf JE. Performance and mood-state parameters during 30-day 6 degrees head-down bed rest with exercise training. Aviat Space Environ Med. 1993 Jun;64(6):522-7.
Reference Type
RESULT
Natelson BH, Deroshia C, Adamus J, Finnegan MB, Levin BE. Relations between visceral and behavioral function in men at bedrest. Pavlov J Biol Sci. 1983 Jul-Sep;18(3):161-8. doi: 10.1007/BF03019168.
Reference Type
RESULT
Kress JP. Clinical trials of early mobilization of critically ill patients. Crit Care Med. 2009 Oct;37(10 Suppl):S442-7. doi: 10.1097/CCM.0b013e3181b6f9c0.
Reference Type
RESULT
Stiller K. Physiotherapy in intensive care: an updated systematic review. Chest. 2013 Sep;144(3):825-847. doi: 10.1378/chest.12-2930.
Reference Type
RESULT
Burnsworth B, Krob MJ, Langer-Schnepp M. Immediate ambulation of patients with lower-extremity grafts. J Burn Care Rehabil. 1992 Jan-Feb;13(1):89-92.
Reference Type
RESULT
Grube BJ, Engrav LH, Heimbach DM. Early ambulation and discharge in 100 patients with burns of the foot treated by grafts. J Trauma. 1992 Nov;33(5):662-4. doi: 10.1097/00005373-199211000-00011.
Reference Type
RESULT
General Principles of Exercise Prescription, in ACSM's Guidelines for Exercise Testing and Prescription, B.A. Franklin, Editor 2006, Lippincott Williams & Wilkins: Philadelphia.
Reference Type
RESULT
Acute Respiratory Distress Syndrome Network; Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000 May 4;342(18):1301-8. doi: 10.1056/NEJM200005043421801.
Reference Type
RESULT
Serpa Neto A, Cardoso SO, Manetta JA, Pereira VG, Esposito DC, Pasqualucci Mde O, Damasceno MC, Schultz MJ. Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA. 2012 Oct 24;308(16):1651-9. doi: 10.1001/jama.2012.13730.
Reference Type
RESULT
Branski LK, Norbury WB, Herndon DN, Chinkes DL, Cochran A, Suman O, Benjamin D, Jeschke MG. Measurement of body composition in burned children: is there a gold standard? JPEN J Parenter Enteral Nutr. 2010 Jan-Feb;34(1):55-63. doi: 10.1177/0148607109336601. Epub 2009 Nov 2.
Reference Type
RESULT
Herndon DN, Hart DW, Wolf SE, Chinkes DL, Wolfe RR. Reversal of catabolism by beta-blockade after severe burns. N Engl J Med. 2001 Oct 25;345(17):1223-9. doi: 10.1056/NEJMoa010342.
Reference Type
RESULT
Przkora R, Herndon DN, Suman OE. The effects of oxandrolone and exercise on muscle mass and function in children with severe burns. Pediatrics. 2007 Jan;119(1):e109-16. doi: 10.1542/peds.2006-1548. Epub 2006 Nov 27.
Reference Type
RESULT
Suman OE, Spies RJ, Celis MM, Mlcak RP, Herndon DN. Effects of a 12-wk resistance exercise program on skeletal muscle strength in children with burn injuries. J Appl Physiol (1985). 2001 Sep;91(3):1168-75. doi: 10.1152/jappl.2001.91.3.1168.
Reference Type
RESULT
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7. doi: 10.1164/ajrccm.166.1.at1102. No abstract available.
Reference Type
RESULT
Brooks D, Solway S, Gibbons WJ. ATS statement on six-minute walk test. Am J Respir Crit Care Med. 2003 May 1;167(9):1287. doi: 10.1164/ajrccm.167.9.950. No abstract available.
Reference Type
RESULT
Bartholomew K, Horowitz LM. Attachment styles among young adults: a test of a four-category model. J Pers Soc Psychol. 1991 Aug;61(2):226-44. doi: 10.1037//0022-3514.61.2.226.
Reference Type
RESULT
Bartholomew, K. and E. Scharfe, Reliability and stability of adult attachment patterns. Personal relationships. J Pers Soc Psychol, 1994. 1: p. 23-43.
Reference Type
RESULT
Other Identifiers
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SHC; IRB #14-0432
Identifier Type: -
Identifier Source: org_study_id