The effects of early physiotherapy on biochemical parameters in major burn patients: A burn center’s experience

BACKGROUND: This study sets out to investigate the effects of early physiotherapy on biochemical parameters in major burn patients.
METHODS: Ten women (50%) and 10 men (50%) aged 21–47 years old were included in this study. Participants were divided into two groups: the first group was the treatment group and the second group was the control group. In the treatment group, patients were admitted to the physiotherapy programme from the first day they have been hospitalised, in addition to their routine treatment (e.g. medical, surgery), for four days per week. The physiotherapy programme consisted of parameters, such as early mobilisation and ambulatory training, chest physiotherapy, and both active and passive normal joint movement exercises. The days of treatment were determined as of Tuesday, Wednesday, Thursday and Friday. Patients could not be treated on a Monday because that was surgery day. The control group consisted of patients who could not receive physiotherapy due to various reasons. All patients included in this study were evaluated weekly for six weeks after admission to the hospital. Parameters, such as demographic information, characteristics of burn injury, C-reactive protein, fibronectin, transferrin and prealbumin, were evaluated.
RESULTS: When the results obtained in this study were considered, there was a significant difference in favour of the treatment group for all biochemical parameters (p<0.05). From the second week, a significant increase was observed in prealbumin values in the treatment group (p<0.05). A significant increase was observed in fibronectin after the fourth week (p<0.05).
CONCLUSION: We believe that early physiotherapy should be included in the treatment in major burns. Early physiotherapy may reduce the effects of hypermetabolic response after major burns. There is a need for multi-centered and broader studies.

Majör yanýklý hastalarda erken dönem fizyoterapinin biyokimyasal parametreler üzerine etkisi: Bir yanýk merkezi deneyimi

AMAÇ: Bu çalýþma, majör yanýklý hastalarda erken dönem fizyoterapinin biyokimyasal parametreler üzerine etkisini araþtýrmak amacýyla planlandý.
GEREÇ VE YÖNTEM: Çalýþmaya, yaþlarý 21–47 arasýnda deðiþen 10 kadýn (%50), 10 erkek (%50) toplam 20 hasta alýndý. Çalýþmaya alýnan hastalar, tedavi ve kontrol gurubu olmak üzere iki gruba ayrýldý. Tedavi grubundaki hastalar, hastaneye yattýklarý ilk günden itibaren rutin tedavilerine (týbbi, cerrahi vs.) ek olarak haftada dört gün olmak üzere fizyoterapi programýna alýndý. Fizyoterapi programý; erken mobilizasyon ve ambulasyon eðitimi, pulmoner fizyoterapi, aktif ve pasif normal eklem hareketi egzersizleri gibi parametreleri içermekteydi. Tedavi günleri salý, çarþamba, perþembe ve cuma günü olarak belirlendi. Pazartesi ameliyat günü olduðundan hastalara tedavi yapýlamadý. Kontrol grubu, çeþitli nedenlerden dolayý fizyoterapi alamayan hastalardan oluþturuldu. Çalýþmaya dahil edilen tüm hastalarýn hastaneye yatýþlarýndan itibaren altý hafta boyunca haftalýk olarak deðerlendirmeleri yapýldý. Deðerlendirmede demografik bilgiler, yanýk hasarýnýn özellikleri, C-reaktif protein, fibronektin, transferrin ve prealbumin gibi parametrelere bakýldý.
BULGULAR: Çalýþmadan elde edilen sonuçlara bakýldýðýnda; tüm biyokimyasal parametrelerde tedavi grubu lehine anlamlý olduðu gözlendi (p<0.05). Prealbuminde tedavi grubunda ikinci haftadan itibaren anlamlý bir yükselme görüldü (p<0.05). Fibronektinde de tedavi grubunda dördüncü haftadan itibaren anlamlý bir artýþ gözlendi (p<0.05).
TARTIÞMA: Erken fizyoterapi yanýk tedavisinin önemli bir parçasýdýr. Majör yanýk sonrasý görülen hipermetabolik cevabýn etikisinin azaltýlmasýnda, erken dönem fizyoterapinin etkili olabileceði görüþündeyiz. Ancak çok merkezli ve daha geniþ çalýþmalara ihtiyaç vardýr.