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Resistance training for rehabilitation after burn injury: A systematic literature review & meta-analysis
Authors:Paul M. Gittings  Tiffany L. Grisbrook  Dale W. Edgar  Fiona M. Wood  Benedict M. Wand  Neil E. O’Connell
Affiliation:1. State Adult Burn Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia;2. Fiona Wood Foundation, Perth, Western Australia, Australia;3. School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia;4. Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia, Australia;5. School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia;6. School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia;g. Health Economics Research Group, Institute of Environment, Health and Societies, Department of Clinical Sciences, Brunel University London, Uxbridge, United Kingdom
Abstract:

Background/aim

Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury.

Methods

Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and rated using the GRADE framework.

Results

Eleven studies matched our inclusion criteria. Primary analysis did not demonstrate significant improvements for increasing muscle strength (SMD 0.74, 95% CI ?0.02 to 1.50, p = 0.06). Sensitivity analysis to correct an apparent anomaly in published data suggested a positive effect (SMD 0.37, 95% CI 0.08–0.65, p = 0.01). Psychological quality of life demonstrated benefit from training (MD = 25.3, 95% CI 3.94–49.7). All studies were rated as having high risk of bias. The quality of the evidence was rated as low or very low.

Conclusion

Further research with robust methodology is recommended to assess the potential benefit suggested in this review.
Keywords:Burns  Resistance training  Rehabilitation  Exercise therapy  Review  meta-analysis
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