The efficacy of resistance training in addition to usual care for adults with acute burn injury: A randomised controlled trial

Resistance training immediately after a burn injury has not been investigated previously. This randomised, controlled trial assessed the impact of resistance training on quality of life plus a number of physical, functional and safety outcomes in adults with a burn injury. Patients were randomly assigned to receive, in addition to standard physiotherapy, four weeks of high intensity resistance training (RTG) or sham resistance training (CG) three days per week, commenced within 72h of the burn injury. Outcome data was collected at six weeks, three and six months after burn injury. Quality of life at 6 months was the primary endpoint. Data analysis was an available cases analysis with no data imputed. Regression analyses were used for all longitudinal outcome data and between-group comparisons were used for descriptive analyses. Forty-eight patients were randomised resistance training (RTG) (n=23) or control group (CG) (n=25). The RTG demonstrated improved outcomes for the functional domain of the Burn Specific Health Scale-Brief (p=0.017) and the Quick Disability of Arm Shoulder and Hand (pp=0.001). Total quality of life scores, lower limb disability, muscle strength and volume were not seen to be different between groups (p\u3e0.05). Resistance training in addition to usual rehabilitation therapy showed evidence of improving functional outcomes, particularly in upper limb burn injuries. Additionally, resistance training commenced acutely after a burn injury was not seen to be harmful to patients. Crown Copyright © 2020 Published by Elsevier Ltd. All rights reserved

Addressing the Barriers to Bioimpedance Spectroscopy Use in Major Burns: Alternate Electrode Placement

© 2017 The American Burn AssociationBioimpedance spectroscopy (BIS) is a method used to assess body composition and fluid distribution. As a technology for measurement of fluid shifts during acute burn resuscitation, there are potential barriers to its use due to the location of wounds. This study aimed to determine whether alternate electrode positions were a suitable alternative compared to standardized (manufacturer) positions in moderate to large size burns for the measurement of BIS resistance and fluid changes. BIS measurements were collected in standard and alternate electrode placements and in an open wound and Acticoat™ dressing condition. A percentage difference greater than 5% between each standard and alternate placement BIS measurements was deemed clinically significant. Chi-square tests determined there were no significant differences (P = .097–.96) between the standard and alternate electrode placements for whole body and limb segment BIS in both dressing conditions. Only whole body BIS resistance variables and extracellular fluid volumes were interchangeable in both dressing conditions and upper limb segmental measures were interchangeable in an open wound only. The differences between measurements of other BIS variables across the conditions were not acceptable or deemed not clinically acceptable without adjustment. The results showed that for moderate to large burn injuries clinicians can use whole body and upper limb segmental BIS variables to monitor changes in fluid shifts with alternate electrode placements where wounds preclude standardized placement within specified dressing conditions

Hip adduction and abduction strength profiles in elite, sub-elite and amateur Australian footballers

© 2015 Sports Medicine Australia. Objectives: It has been reported that obtaining an adduction-to-abduction strength ratio of 90-100%, and an adduction strength equal to that of the uninjured side, are suitable clinical milestones for return to sport following groin injury. Little is known about hip adduction and abduction strength profiles in Australian footballers. This study aimed to compare isometric hip adduction and abduction strength profiles between preferred and non-preferred kicking legs in elite, sub-elite and amateur Australian footballers. Design: Cross sectional study. Methods: 36 elite, 19 sub-elite and 18 amateur Australian footballers, with a mean age of 24, 19 and 23 years respectively, were included. Maximal hip isometric adduction and abduction strength were measured using a hand held dynamometer with external belt fixation. Results: There were no significant differences in isometric hip adduction (p = 0.262) or abduction (p = 0.934) strength, or the adduction-to-abduction ratio (p = 0.163), between preferred and non-preferred kicking legs, regardless of playing level. Elite players had significantly greater isometric hip adduction and abduction strength than both sub-elite (mean difference; adduction = 46.01. N, p <. 0.001, abduction = 30.79. N, p = 0.003) and amateur players (mean difference; adduction = 78.72. N, p <. 0.001, abduction = 59.11. N, p <. 0.001). There was no significant difference in the adduction-to-abduction ratio between the playing levels (p = 0.165). Conclusions: No significant differences were found between preferred and non-preferred kicking legs across the playing levels for isometric hip adduction, abduction or the adduction-to-abduction ratio. This may have implications for developing groin injury prediction and return to sport criteria in Australian footballers

Predicting 1 Repetition Maximum Using Handheld Dynamometry.

BACKGROUND: Isometric assessment of muscular function using a handheld dynamometer (HHD) is frequently used in clinic environments. However, there is controversy in terms of the validity of isometric assessment to monitor changes in dynamic performance. One repetition maximum (1RM) is considered the gold standard for evaluating dynamic strength, though clinicians do not often use 1RM testing, preferring to be cautious with clients who have preexisting impairments. If strength testing using an HHD could be used to predict 1RM, this may have significant implications for the use of isometric testing to prescribe exercise in clinical environments. OBJECTIVE: To establish the relationship and agreement between 1RM and isometric strength scores measured using HHD for the biceps and quadriceps muscle groups and to determine if HHD measurements can be used to predict 1RM. DESIGN: Criterion standard comparison. SETTING: Tertiary institution gymnasium. PARTICIPANTS: Convenience sample of 50 healthy adults (26 women) aged 19-33 years (mean 23.38 ± 3.11 years). METHODS: Muscle strength of the biceps and quadriceps muscle groups measured by 1RM and isometric maximal voluntary contraction measured using an HHD. MAIN OUTCOME MEASURES: Statistical analysis of the relation between the measures of strength was established using Pearson correlation and a Bland-Altman plot. A linear regression analysis with included covariates (gender, age, resistance training history, and body mass index) was used to derive the prediction equations. RESULTS: A significant correlation was found between 1RM and HHD scores for the biceps (r = .83, P < .001) and quadriceps muscle groups (r = .82, P < .001). However, strength scores were not in agreement. Linear regression analysis found significance in predicting 1RM from all HHD scores (P < .001). Gender as a covariate significantly influenced the prediction of 1RM for the biceps (P = .005) and quadriceps (P = .003) muscle groups. CONCLUSIONS: There is a significant relationship between 1RM and HHD measures of strength, and measures taken using an HHD can be used to predict 1RM in the biceps and quadriceps muscle groups. The use of an HHD may therefore provide a more accessible alternative to 1RM for muscle strength assessments. Further research is warranted to determine if results are applicable in clinical populations