Six Months of Exercise Training Improves Ventilatory Responses during Exercise in Adults with Well-Healed Burn Injuries.
Journal
Medicine and science in sports and exercise
ISSN: 1530-0315
Titre abrégé: Med Sci Sports Exerc
Pays: United States
ID NLM: 8005433
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
pmc-release:
01
05
2024
medline:
17
4
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Pulmonary function is lower after a severe burn injury, which could influence ventilatory responses during exercise. It is unclear whether exercise training improves pulmonary function or ventilatory responses during exercise in adults with well-healed burn injuries. Therefore, we tested the hypothesis that exercise training improves pulmonary function and ventilatory responses during exercise in adults with well-healed burn injuries. Thirty-nine adults (28 with well-healed burn injuries and 11 non-burn-injured controls) completed 6 months of unsupervised, progressive exercise training including endurance, resistance, and high-intensity interval components. Before and after exercise training, we performed comprehensive pulmonary function testing and measured ventilatory responses during cycling exercise. We compared variables using two-way ANOVA (group-time; i.e., preexercise/postexercise training (repeated factor)). Exercise training did not increase percent predicted spirometry, lung diffusing capacity, or airway resistance measures (time: P ≥ 0.14 for all variables). However, exercise training reduced minute ventilation ( V̇E ; time: P ≤ 0.05 for 50 and 75 W) and the ventilatory equivalent for oxygen ( V̇E /V̇O 2 ; time: P < 0.001 for 75 W) during fixed-load exercise for both groups. The ventilatory equivalent for carbon dioxide ( V̇E /V̇CO 2 ) during exercise at 75 W was reduced after exercise training (time: P = 0.04). The percentage of age-predicted maximum heart rate at the ventilatory threshold was lower in adults with well-healed burn injuries before ( P = 0.002), but not after ( P = 0.22), exercise training. Lastly, exercise training increased V̇E and reduced V̇E /V̇O 2 during maximal exercise (time: P = 0.005 for both variables). These novel findings demonstrate that exercise training can improve ventilatory responses during exercise in adults with well-healed burn injuries.
Identifiants
pubmed: 36729937
doi: 10.1249/MSS.0000000000003099
pii: 00005768-202305000-00001
pmc: PMC10106361
mid: NIHMS1854069
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
765-776Subventions
Organisme : NIGMS NIH HHS
ID : R01 GM068865
Pays : United States
Organisme : NHLBI NIH HHS
ID : F32 HL154559
Pays : United States
Organisme : NIGMS NIH HHS
ID : F32 GM117693
Pays : United States
Informations de copyright
Copyright © 2022 by the American College of Sports Medicine.
Références
Porter C, Hardee JP, Herndon DN, Suman OE. The role of exercise in the rehabilitation of patients with severe burns. Exerc Sport Sci Rev . 2015;43(1):34–40.
Duke JM, Randall SM, Fear MW, Boyd JH, Rea S, Wood FM. Respiratory morbidity after childhood burns: a 10-year follow-up study. Pediatrics . 2016;138(4):e20161658.
Mason SA, Nathens AB, Byrne JP, et al. Increased rate of long-term mortality among burn survivors: a population-based matched cohort study. Ann Surg . 2019;269(6):1192–9.
Willis CE, Grisbrook TL, Elliott CM, Wood FM, Wallman KE, Reid SL. Pulmonary function, exercise capacity and physical activity participation in adults following burn. Burns . 2011;37(8):1326–33.
Whitener DR, Whitener LM, Robertson KJ, Baxter CR, Pierce AK. Pulmonary function measurements in patients with thermal injury and smoke inhalation. Am Rev Respir Dis . 1980;122(5):731–9.
Won YH, Cho YS, Joo SY, Seo CH. Respiratory characteristics in patients with major burn injury and smoke inhalation. J Burn Care Res . 2022;43(1):70–6.
Özkal Ö, Topuz S, Karahan S, Erdem MM, Konan A, Yastı A. Clinical predictors of pulmonary functions, respiratory/peripheral muscle strength and exercise capacity at discharge in adults with burn injury. Disabil Rehabil . 2021;43(20):2875–81.
Won YH, Cho YS, Joo SY, Seo CH. The effect of a pulmonary rehabilitation on lung function and exercise capacity in patients with burn: a prospective randomized single-blind study. J Clin Med . 2020;9(7):2250.
Björnhagen V, Schüldt Ekholm K, Larsen F, Ekholm J. Burn survivors’ pulmonary and muscular impairment, exercise tolerance and return-to-work following medical-vocational rehabilitation: a long-term follow-up. J Rehabil Med . 2018;50(5):465–71.
Grisbrook TL, Wallman KE, Elliott CM, Wood FM, Edgar DW, Reid SL. The effect of exercise training on pulmonary function and aerobic capacity in adults with burn. Burns . 2012;38(4):607–13.
Suman OE, Mlcak RP, Herndon DN. Effect of exercise training on pulmonary function in children with thermal injury. J Burn Care Rehabil . 2002;23(4):288–93.
Mlcak R, Desai MH, Robinson E, Nichols R, Herndon DN. Lung function following thermal injury in children—an 8-year follow up. Burns . 1998;24(3):213–6.
Nylen ES, Jeng J, Jordan MH, et al. Late pulmonary sequela following burns: persistence of hyperprocalcitonemia using a 1–57 amino acid N-terminal flanking peptide assay. Respir Med . 1995;89(1):41–6.
Mlcak RP, Desai MH, Robinson E, McCauley RL, Richardson J, Herndon DN. Increased physiological dead space/tidal volume ratio during exercise in burned children. Burns . 1995;21(5):337–9.
Watso JC, Romero SA, Moralez G, et al. Adults with well-healed burn injuries have lower pulmonary function values decades after injury. Physiol Rep . 2022;10(10):e15264.
Romero SA, Moralez G, Jaffery MF, et al. Exercise training improves microvascular function in burn injury survivors. Med Sci Sports Exerc . 2020;52(11):2430–6.
Huang M, Moralez G, Romero SA, et al. The benefits of an unsupervised exercise program in persons with well-healed burn injuries within the International Classification of Functioning, Disability and Health (ICF). Burns . 2020;46(6):1280–8.
Romero SA, Moralez G, Jaffery MF, et al. Progressive exercise training improves maximal aerobic capacity in individuals with well-healed burn injuries. Am J Physiol Regul Integr Comp Physiol . 2019;317(4):R563–70.
de Lateur BJ, Shore WS. Exercise following burn injury. Phys Med Rehabil Clin N Am . 2011;22(2):347–50 vii.
Cheng Y, Macera C, Addy C, Sy F, Wieland D, Blair SN. Effects of physical activity on exercise tests and respiratory function. Br J Sports Med . 2003;37(6):521–8.
Belman MJ, Kendregan BA. Physical training fails to improve ventilatory muscle endurance in patients with chronic obstructive pulmonary disease. Chest . 1982;81(4):440–3.
Vogiatzis I, Williamson AF, Miles J, Taylor IK. Physiological response to moderate exercise workloads in a pulmonary rehabilitation program in patients with varying degrees of airflow obstruction. Chest . 1999;116(5):1200–7.
Orenstein DM, Franklin BA, Doershuk CF, et al. Exercise conditioning and cardiopulmonary fitness in cystic fibrosis. The effects of a three-month supervised running program. Chest . 1981;80(4):392–8.
Alison JA, Donnelly PM, Lennon M, et al. The effect of a comprehensive, intensive inpatient treatment program on lung function and exercise capacity in patients with cystic fibrosis. Phys Ther . 1994;74(6):583–91; discussion 591-3.
Won YH, Cho YS, Kim DH, Joo SY, Seo CH. Relation between low pulmonary function and skeletal muscle index in burn patients with major burn injury and smoke inhalation: a retrospective study. J Burn Care Res . 2020;41(3):695–9.
Ganio MS, Pearson J, Schlader ZJ, et al. Aerobic fitness is disproportionately low in adult burn survivors years after injury. J Burn Care Res . 2015;36(4):513–9.
Harms CA, Wetter TJ, McClaran SR, et al. Effects of respiratory muscle work on cardiac output and its distribution during maximal exercise. J Appl Physiol (1985) . 1998;85(2):609–18.
Rafferty GF, Lou Harris M, Polkey MI, Greenough A, Moxham J. Effect of hypercapnia on maximal voluntary ventilation and diaphragm fatigue in normal humans. Am J Respir Crit Care Med . 1999;160(5 Pt 1):1567–71.
Bai TR, Rabinovitch BJ, Pardy RL. Near-maximal voluntary hyperpnea and ventilatory muscle function. J Appl Physiol Respir Environ Exerc Physiol . 1984;57(6):1742–8.
Chlif M, Chaouachi A, Ahmaidi S. Effect of aerobic exercise training on ventilatory efficiency and respiratory drive in obese subjects. Respir Care . 2017;62(7):936–46.
Watso JC, Romero SA, Moralez G, et al. Six months of unsupervised exercise training lowers blood pressure during moderate, but not vigorous, aerobic exercise in adults with well-healed burn injuries. J Appl Physiol (1985) . 2022;133(3):742–54.
Graham BL, Steenbruggen I, Miller MR, et al. Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med . 2019;200(8):e70–88.
Graham BL, Brusasco V, Burgos F, et al. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J . 2017;49(1):1600016.
Quanjer PH, Stanojevic S, Cole TJ, et al. Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations. Eur Respir J . 2012;40(6):1324–43.
Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med . 1999;159(1):179–87.
Kory RC, Callahan R, Boren HG, Syner JC. The Veterans Administration–Army cooperative study of pulmonary function. I. Clinical spirometry in normal men. Am J Med . 1961;30:243–58.
Grimby G, Soderholm B. Spirometric studies in normal subjects: III. Static lung volumes and maximum voluntary ventilation in adults with a note on physical fitness 1. Acta Med Scand . 1963;173(2):199–206.
Hall GL, Filipow N, Ruppel G, et al. Official ERS technical standard: Global Lung Function Initiative reference values for static lung volumes in individuals of European ancestry. Eur Respir J . 2021;57(3):2000289.
Stanojevic S, Graham BL, Cooper BG, et al. Official ERS technical standards: Global Lung Function Initiative reference values for the carbon monoxide transfer factor for Caucasians. Eur Respir J . 2017;50(3):1700010.
Dubois AB, Botelho SY, Comroe JH Jr. A new method for measuring airway resistance in man using a body plethysmograph: values in normal subjects and in patients with respiratory disease. J Clin Invest . 1956;35(3):327–35.
Hollowell JG, van Assendelft OW, Gunter EW, Lewis BG, Najjar M, Pfeiffer C; Centers for Disease Control and Prevention, National Center for Health Statistics. Hematological and iron-related analytes—reference data for persons aged 1 year and over: United States, 1988–94. Vital Health Stat 11 . 2005;(247):1–156.
Sun X-G, Hansen JE, Garatachea N, Storer TW, Wasserman K. Ventilatory efficiency during exercise in healthy subjects. Am J Respir Crit Care Med . 2002;166(11):1443–8.
Kennedy MC. A practical measure of the maximum ventilatory capacity in health and disease. Thorax . 1953;8(1):73–83.
Cara M. Bases physiques pour un essai de mécanique ventilatoire avec application a la cinésitherapie [Physical basis for test of ventilation mechanism with application to kinesitherapy]. Poumon . 1953;9(5–6):371–428.
Campbell SC. A comparison of the maximum voluntary ventilation with the forced expiratory volume in one second: an assessment of subject cooperation. J Occup Med . 1982;24(7):531–3.
Gandevia B, Hugh-Jones P. Terminology for measurements of ventilatory capacity; a report to the thoracic society. Thorax . 1957;12(4):290–3.
Dillard TA, Hnatiuk OW, McCumber TR. Maximum voluntary ventilation. Spirometric determinants in chronic obstructive pulmonary disease patients and normal subjects. Am Rev Respir Dis . 1993;147(4):870–5.
Lavin KM, Guenette JA, Smoliga JM, Zavorsky GS. Controlled-frequency breath swimming improves swimming performance and running economy. Scand J Med Sci Sports . 2015;25(1):16–24.
Straub AM, Midgley AW, Zavorsky GS, Hillman AR. Ramp-incremented and RPE-clamped test protocols elicit similar VO 2 max values in trained cyclists. Eur J Appl Physiol . 2014;114(8):1581–90.
Gandevia S. Publications, replication and statistics in physiology plus two neglected curves. J Physiol . 2021;599(6):1719–21.
Curran-Everett D. Evolution in statistics: P values, statistical significance, kayaks, and walking trees. Adv Physiol Educ . 2020;44(2):221–4.
Howden EJ, Perhonen M, Peshock RM, et al. Females have a blunted cardiovascular response to one year of intensive supervised endurance training. J Appl Physiol (1985) . 2015;119(1):37–46.
Balmain BN, Weinstein K, Bernhardt V, Marines-Price R, Tomlinson AR, Babb TG. Multidimensional aspects of dyspnea in obese patients referred for cardiopulmonary exercise testing. Respir Physiol Neurobiol . 2020;274:103365.
Blackie SP, Fairbarn MS, McElvaney NG, Wilcox PG, Morrison NJ, Pardy RL. Normal values and ranges for ventilation and breathing pattern at maximal exercise. Chest . 1991;100(1):136–42.
Abazarnejad E, Froutan R, Ahmadabadi A, Mazlom SR. Improving respiratory muscle strength and health status in burn patients: a randomized controlled trial. Qual Life Res . 2022;31(3):769–76.