Investigation of the Effect of Exercise Protocol Determined According to Metabolic Rate in Early Burn Patients on Coagulation, Fibrinolytic Activity and Functional Capacity
Condition: Burns
MeSH terms: Burns
Study type: Interventional

Summary: 
      The aim of this study is; To investigate the Effect of the Exercise Protocol Determined
      According to Metabolic Rate in Early Burn Patients on Coagulation, Fibrinolytic Activity and
      Functional Capacity, and to create an exercise protocol that can guide researchers working in
      burn patients and physiotherapists working in burn centers at national and international
      level.

      The study, which is planned to be carried out in Hasan Kalyoncu University Faculty of Health
      Sciences Department of Physiotherapy and Rehabilitation, will be included in the burn
      patients in the 25 Aralık State Hospital Burn Center, service and intensive care unit.
    

Detailed description: 
      Burn injury is one of the longest traumas, causing serious mortality and morbidity, and the
      length of hospital stay and rehabilitation period.

      For optimal treatment after burns, all pathophysiological changes that may occur locally and
      systemically after injury should be well known.

      Along with surgical and medical treatments, the role of early exercise in burn treatment is
      becoming more and more important.

      Burn patients need a long rehabilitation period, including the acute period and the
      post-discharge period.

      Early exercise is very important, especially in burn intensive care units, for healing of
      burns and minimizing the effects of hypermetabolism. Exercises should be started from the
      first day the patient is hospitalized.

      In a study on physiotherapists working in 6 major burn centers in the United States, stated
      that all physiotherapists applied various exercises in the early period in burn patients, but
      these exercises varied in all centers in terms of characteristics such as type and frequency.
      In the same study, it was emphasized that exercise programs, which are the biggest help in
      reducing intensive care periods in burn patients, should be more consistent and there is a
      need for studies investigating the components of the exercises.

      Stated in another study that the exercise program applied in the early period in burns does
      not have an internationally accepted standard and studies should be done to create an
      exercise prescription.

      In recent years, it has been emphasized that exercise protocols differ between
      physiotherapists and that there is no international standardization in questionnaire studies
      on exercise protocols applied to burn patients.

      In addition, it has been emphasized that studies investigating exercise components will
      contribute more to the burn literature.

      The aim of this study is; To investigate the Effect of the Exercise Protocol Determined
      According to Metabolic Rate in Early Burn Patients on Coagulation, Fibrinolytic Activity and
      Functional Capacity, and to create an exercise protocol that can guide researchers working in
      burn patients and physiotherapists working in burn centers at national and international
      level.

      The study, which is planned to be carried out in Hasan Kalyoncu University Faculty of Health
      Sciences Department of Physiotherapy and Rehabilitation, will be included in the burn
      patients in the 25 Aralık State Hospital Burn Center, service and intensive care unit.

      Inclusion criteria

        -  Conscious patients

        -  Enterally fed

        -  >18 years old Exclusion criteria

        -  With inhalation burn

        -  In addition to existing burn trauma, those with other trauma (fracture, loss of limb,
           etc.)

        -  Organ dysfunctions or multiple organ failure

        -  History of chronic diseases such as diabetes, cholesterol and blood pressure

        -  prothrombin time> 14.6 sec A total of 30 patients, 10 patients for each group, were
           planned to be included in the study.

      The individuals participating in the study will be divided into 3 groups: Standard therapy
      (1st Group), Standard therapy + bicycle ergometer (2nd Group) and Standard therapy + exercise
      protocol to be developed (3rd Group)

      Assessment of Coagulation and Fibrinolytic Activity

      Prothrombin time Platelet D-dimer, Fibrinogen

      These parameters will be monitored 3 days a week for 6 weeks (These parameters will be
      monitored 3 days a week for 6 weeks (These biochemistry parameters are routinely checked in
      every patient at the 25 December State Hospital Burn Center)

      Evaluation of Functional Capacity 6 min walking test Physiological consumption index MRC
      scale (general muscle strength measurement scale used in intensive care patients)

      These parameters will be monitored weekly (once a week) for 6 weeks.

      Evaluation of Basal Metabolism

      For basal metabolism, "hand held device" indirect calorimeter will be used and individuals in
      each group will be evaluated and monitored daily.
    

Intervention name(s): Control Group/1st group ( standard physiotherapy; 2nd group- Standard physiotherapy + bicycle ergometer; 3rd group- Standard physiotherapy + exercise protocol to be developed
Intervention type(s): Other; Other; Other
Intervention description(s): It comprised of parameters such as early mobilization and ambulatory training, pulmonary physiotherapy, active and passive normal joint movement exercises.; Standard physiotherapy + bicycle ergometer: In addition to the standard therapy, a bicycle ergometer for 20 minutes 5 days a week will be given.
Patients will turn the pedals of the bicycle while sitting on the edge of the bed.
In this protocol, a portable bicycle with adjustable pedal system, which can be placed on the edge of the bed, will be used.
"Ratings of perceived exertion (RPE)" will be used to determine the intensity of aerobic activity. According to the RPE, 10-12 strength exercises will be given.; Standard physiotherapy + exercise protocol to be developed: In addition to standard therapy, exercise will be given according to the measured basal metabolic rate of the patients.
Portable indirect calorimetry will be used to measure the basal metabolic rates of the patients.
The basal metabolic rates of the patients will be measured before the exercise and aerobic exercise or resistant exercise will be given according to the metabolic state of the patient.
Ratings of perceived exertion (RPE) will be used as the aerobic exercise protocol and a 10-11 strength exercise will be given according to the RPE.
If resistance exercise will be given, the intensity of the exercise (12-14) will be determined according to the RPE. Sandbags attached to the ankle will be used as a resistance exercise and 9 exercises were determined. (Knee extension, knee flexion, trunk flexion, trunk extension, hip extension, hip flexion, hip abduction, shoulder flexion, shoulder abduction
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A total of 30 patients, 10 patients for each group, were planned to be included in the study.
The individuals participating in the study will be divided into 3 groups: Standard therapy (1st Group), Standard therapy + bicycle ergometer (2nd Group) and Standard therapy + exercise protocol to be developed (3rd Group)
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: physiotherapy; Burn rehabilitation; Major burns