Exercise in Burn Survivors: Cooling Modalities

NCT ID: NCT04512976

Last Updated: 2025-07-28

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-15

Study Completion Date

2023-03-01

Brief Summary

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This project will identify the efficacy of cooling modalities aimed to attenuate excessive elevations in skin and internal body temperatures during physical activity in well-healed burn survivors. The investigators will conduct a randomized crossover design study. Non-burned control subjects, subjects who experienced burns covering \~20% to 40% of their body surface area, and subject having burns \>40% of their body surface area will be investigated. Subjects will exercise in heated environmental conditions while receiving the following cooling modalities: no cooling, fan only, skin wetting only, and a combination of fan and skin wetting.

Detailed Description

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Within the United States, 500,000+ individuals are enduring the long-term consequences of severe burn injuries covering 20% or more of their body surface area, with upwards to 11,000 individuals experiencing such an injury per year. These burn injuries can severely compromise body temperature regulation, owing to permanent impairments in the primary thermoeffectors necessary to dissipate heat, namely profoundly blunted skin blood flow and sweating responses in the injured skin. The investigators propose that this heat intolerance deters burn survivors from participating in physical activity, including activities of daily living, necessary to avoid the adverse cardiovascular and metabolic sequela of a sedentary lifestyle. Consistent with hypothesis, years after the injury burn survivors have a very low aerobic capacity; greater all-cause mortality rates; greater hospitalization days for circulatory diseases; and suffer from greater incidences of ischemic heart disease, heart failure, diabetes, and cerebrovascular disease (including stroke) relative to matched non-burned cohorts. The primary goal of this project is to identify modalities to attenuate excessive elevations in skin and core body temperatures during physical activity in well-healed burn survivors. The implementation of such modalities will eliminate heat intolerance as a barrier to participation in activities that are necessary to improve/maintain cardiovascular health in this vulnerable population. This project will investigate whether increased skin wetness, with and without accompanying fan use, will restore otherwise impaired evaporative cooling of well-healed burn survivors, with the extent of that improvement predicated on the environmental conditions and the percentage of body surface area burned.

Conditions

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Burn Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

The investigators will conduct a randomized crossover design study. Burn survivors (20-40% burn surface area), burn survivors (\>40% burn surface area), and non-burned individuals will each perform four bouts of 60-min of exercise trials with the following cooling strategies: A) a control trial, B) skin wetting only trial, C) fan only trial, and D) a combination of skin wetting with a fan trial. Subjects will perform these four bouts under one of the following environmental conditions (30 deg C and 38 deg C).

A subject will only be required to perform exercise across all four cooling modalities for a given environmental temperature (i.e., four exercise bouts); each will not be required to perform exercise across all combinations of environmental temperatures and cooling modalities (i.e., 12 exercise bouts).
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

No masking is required as each subject will be exposed to each cooling modality (e.g., fan only, skin wetting, and a combination of a fan and skin wetting).

Study Groups

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Burn Survivors (20-40% Burn Surface Area) in Ambient Heat (30°C)

Burn survivors with 20-40% BSA (burn surface area) will exercise for 60 minutes in ambient heat (30°C) while being exposed to each of the following cooling modalities: no cooling, fan only, skin wetting only, and a combination of a fan and skin wetting.

Group Type EXPERIMENTAL

Control (no cooling modalities)

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to no cooling modality.

Water Spray Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the skin wetting modality.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Fan Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the fan cooling modality.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Water Spray and Fan

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to both the skin wetting and fan cooling modalities.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Burn Survivors (20-40% Burn Surface Area) in Ambient Heat (39°C)

Burn survivors with 20-40% BSA (burn surface area) will exercise for 60 minutes in ambient heat (39°C) while being exposed to each of the following cooling modalities: no cooling, fan only, skin wetting only, and a combination of a fan and skin wetting.

Group Type EXPERIMENTAL

Control (no cooling modalities)

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to no cooling modality.

Water Spray Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the skin wetting modality.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Fan Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the fan cooling modality.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Water Spray and Fan

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to both the skin wetting and fan cooling modalities.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Non-Burned Individuals in Ambient Heat (30°C)

Non-burned individuals will exercise for 60 minutes in ambient heat (30°C) while being exposed to each of the following cooling modalities: no cooling, fan only, skin wetting only, and a combination of a fan and skin wetting.

Group Type EXPERIMENTAL

Control (no cooling modalities)

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to no cooling modality.

Water Spray Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the skin wetting modality.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Fan Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the fan cooling modality.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Water Spray and Fan

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to both the skin wetting and fan cooling modalities.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Non-Burned Individuals in Ambient Heat (39°C)

Non-burned individuals will exercise for 60 minutes in ambient heat (39°C) while being exposed to each of the following cooling modalities: no cooling, fan only, skin wetting only, and a combination of a fan and skin wetting.

Group Type EXPERIMENTAL

Control (no cooling modalities)

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to no cooling modality.

Water Spray Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the skin wetting modality.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Fan Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the fan cooling modality.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Water Spray and Fan

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to both the skin wetting and fan cooling modalities.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Burn Survivors (>40% Burn Surface Area) in Ambient Heat (30°C)

Burn survivors with \>40% BSA (burn surface area) will exercise for 60 minutes in ambient heat (30°C) while being exposed to each of the following cooling modalities: no cooling, fan only, skin wetting only, and a combination of a fan and skin wetting.

Group Type EXPERIMENTAL

Control (no cooling modalities)

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to no cooling modality.

Water Spray Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the skin wetting modality.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Fan Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the fan cooling modality.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Water Spray and Fan

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to both the skin wetting and fan cooling modalities.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Burn Survivors (>40% Burn Surface Area) in Ambient Heat (39°C)

Burn survivors with \>40% BSA (burn surface area) will exercise for 60 minutes in ambient heat (39°C) while being exposed to each of the following cooling modalities: no cooling, fan only, skin wetting only, and a combination of a fan and skin wetting.

Group Type EXPERIMENTAL

Control (no cooling modalities)

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to no cooling modality.

Water Spray Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the skin wetting modality.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Fan Only

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the fan cooling modality.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Water Spray and Fan

Intervention Type OTHER

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to both the skin wetting and fan cooling modalities.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Interventions

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Control (no cooling modalities)

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to no cooling modality.

Intervention Type OTHER

Water Spray Only

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the skin wetting modality.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Intervention Type OTHER

Fan Only

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to the fan cooling modality.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Intervention Type OTHER

Water Spray and Fan

Subjects will exercise for 60 minutes in the indicated environmental condition while being exposed to both the skin wetting and fan cooling modalities.

The fan will be a commercially available fan will be directed to the research subject throughout the exercise bout.

Skin wetting will be performed by spraying water onto the skin throughout the exercise bout.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Healthy male and female subjects
* 18-65 years of age.
* Free of any underlying medical conditions


* Healthy male and female subjects
* 18-65 years of age.
* Free of any underlying medical conditions
* Having a burn injury covering 20-40% or \>40% of the participant's body surface area; at least 50% of those burn injuries must be full thickness that required skin grafting.
* Participants must have been hospitalized due to the burn injury for a minimum of 15 days

Exclusion Criteria

* Any burn-related injuries resulting in at least one night of hospitalization.
* Heart disease or any other chronic medical condition requiring regular medical therapy including cancer, diabetes, and hypertension.
* Abnormalities detected on routine screening
* Individuals who participate in a structured aerobic exercise training program at moderate to high intensities.
* Current smokers, as well as individuals who regularly smoked within the past 3 years.
* Body mass index of greater than 30 kg/m\^2.
* Pregnant individuals


* Any burn-related injuries resulting in at least one night of hospitalization.
* Heart disease or any other chronic medical condition requiring regular medical therapy including cancer, diabetes, and hypertension.
* Abnormalities detected on routine screening
* Individuals who participate in a structured aerobic exercise training program at moderate to high intensities.
* Current smokers, as well as individuals who regularly smoked within the past 3 years.
* Body mass index of greater than 30 kg/m\^2.
* Pregnant individuals
* Extensive unhealed injured skin
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of General Medical Sciences (NIGMS)

NIH

Sponsor Role collaborator

University of Texas Southwestern Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Craig Crandall

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Institute for Exercise and Environmental Medincine - Texas Health Presbyterian Hospital Dallas

Dallas, Texas, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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2R01GM068865-13A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STU_2020_0334

Identifier Type: -

Identifier Source: org_study_id

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