Burn survivors’ pulmonary and muscular impairment, exercise tolerance and return-to-work following medical-vocational rehabilitation: A long-term follow-up

• Main Authors: Viveca Björnhagen, Kristina Schüldt Ekholm, Flemming Larsen, Jan Ekholm
• Format: Article
• Language: English
• Published: Foundation for Rehabilitation Information 2018-04-01
• Series: Journal of Rehabilitation Medicine
• Subjects: burninjury; returntowork; medicalrehabilitation; vocationalrehabilitation; cardio-pulmonaryexercisecapacity; lungscintigraphy; pulmonaryfunction; musclefunction
• Online Access: https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2337
• ISSN: 1650-1977; 1651-2081

Objective: To follow up the long-term outcome in return-to-work (RTW) rate in burn-injury patients, and to determine the degree of impairment in pulmonary and muscular function and exercise tolerance. Design: A prospective, longitudinal follow-up study without a control group. Patients: Twenty-five burn-injury patients referred for medical-vocational rehabilitation. Methods: Return-to-work rate was followed after completed medical-vocational rehabilitation. Pulmonary function was evaluated with spirometry, diffusing capacity and radio spirometry. Exercise capacity was determined using a bicycle ergometer. Muscle functions evaluated in the arms and legs were: isokinetic torque, isometric strength, endurance and muscular strength utilization. Results: Return-to-work rate was 87%. During bicycle exercise tests the patients, on average, reached their expected workloads. The dominating lung func-tion abnormality observed on lung scintigraphy was delayed wash-out time of inhaled radioactive xenon gas, suggesting airway obstruction. All tests of shoulder-flexor and knee-extensor muscle function showed large minimum–maximum differences. Mean isometric endurance of shoulder flexors was lower than mean of references, and isokinetic knee extensor torques were slightly lower. Conclusion: High return-to-work rates can be achieved after burn injury requiring hospital-ward care. Despite measurable impairments in muscle strength/endurance and pulmonary function in a substantial proportion of these patients, overall normal bicycle exercise capacity was observed except for a few cases.