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Effect of early and late outpatient exercise training on muscle mass and protein kinetics in severely burned children (702.5)

Severe thermal trauma is associated with profound muscle wasting and long‐term functional impairments in burn survivors. Late exercise training performed 6 to 9 months post‐injury increases leg lean mass (LM) in burned children. The impact of early outpatient exercise, initiated immediately following hospital discharge, on muscle mass has yet to be examined. Therefore, we examined the effects of early and late outpatient rehabilitative exercise training (RET) on muscle mass and protein kinetics in severely burned children. Eighty‐six children with 蠅40% total body surface area burn were randomized to 12‐weeks standard of care rehabilitation (SoC) or RET at discharge (DC) and 6 months (6M) post‐burn. DEXA was used to determine changes in LM. In a subset of patients (N=30), stable isotope infusion studies were conducted to determine muscle protein synthesis (MPS). RET increased LM compared to SoC at each time‐point (DC: 4.7% vs 17.0%; 6M: 3.0% vs 13.0%). No differences in LM were found between RET interventions. MPS decreased from DC to 6M (6.3 ± 1.4% and 3.4 ± 0.6%, respectively); however no differences were observed between SoC and RET. No changes in MPS were observed from 6 to 9 months. In addition, no differences in blood flow were found with each treatment. These results demonstrate that improvements in LM can be achieved immediately following hospital discharge and 6 months post‐burn without alterations to basal muscle protein turnover. Early and late outpatient RET are effective methods to augment muscle mass following severe burn injury.