Skip to main content

Advertisement

SpringerLink
Log in

Improving respiratory muscle strength and health status in burn patients: a randomized controlled trial

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Pulmonary complications are among the major disadvantages of burns. The present study aimed to determine the effect of inspiratory muscle training on respiratory muscle strength and health status in burned patients.

Methods

The current randomized clinical trial was conducted on 64 burned patients in Burn Center of Imam Reza Hospital, Mashhad, Iran. In the intervention group, a Powerbreathe device (KH1 digital model) was used twice a day for 10 days, accompanied by the routine procedures and in the control group, only chest physiotherapy and incentive spirometer were used.

Results

Before the intervention, the mean scores of respiratory muscle strength were 38.8 ± 10.1 and 35.8 ± 9.0 in the Powerbreathe group and control group, respectively (p = .206). After the intervention, the mean score of respiratory muscle strength of Powerbreathe group was 49.2 ± 11.8 and in the control group was 39.3 ± 8.5 (p < 0.001). Moreover, the mean scores of health status before the intervention in the burned patients were 66.3 ± 14.8 and 63.0 ± 17.3 in the Powerbreathe group and control group, respectively (p = 0.550). In the post-intervention phase, the mean health status score of the burned patients in the intervention and control groups were measured at 75.9 ± 14.1 and 66.7 ± 15.9, respectively (p = 0.019).

Conclusion

It seems that inspiratory muscle training improves respiratory muscle strength and health status in the burned patients. Therefore, the use of Powerbreathe is recommended for the prevention and improvement of pulmonary complications in patients with chest burns.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not Applicable.

References

  1. Saberi, M., Fatemi, M. J., Soroush, M. R., Masoumi, M., & Niazi, M. (2016). Burn epidemiology in iran: a meta-analysis study. Iranian journal of surgery, 24(1), 47–61.

    Google Scholar 

  2. World Health Organization. (2011). Burn prevention: success stories and lessons learned (No. 9241501189). Geneva: Switzerland.

  3. Nielson, C. B., Duethman, N. C., Howard, J. M., Moncure, M., & Wood, J. G. (2017). Burns: pathophysiology of systemic complications and current management. Journal of Burn Care & Research, 38(1), e469–e481.

    Article  Google Scholar 

  4. Boots, R. J., Dulhunty, J. M., Paratz, J., & Lipman, J. (2009). Respiratory complications in burns: an evolving spectrum of injury. Clinical Pulmonary Medicine, 16(3), 132–138.

    Article  Google Scholar 

  5. Mansour, O., Megahed, M., El-Wahsh, R., El-Helbawy, R., & Abd El-Azeem, N. (2017). Pulmonary complications for predicting mortality among major burn victims. Menoufia Medical Journal, 30(1), 234–240.

    Article  Google Scholar 

  6. Basso-Vanelli, R. P., Di Lorenzo, V. A. P., Ramalho, M., Labadessa, I. G., Regueiro, E. M. G., Jamami, M., & Costa, D. (2018). Reproducibility of inspiratory muscle endurance testing using PowerBreathe for COPD patients. Physiotherapy Research International, 23(1), e1687.

    Article  Google Scholar 

  7. Jeschke, M. G., Chinkes, D. L., Finnerty, C. C., Kulp, G., Suman, O. E., Norbury, W. B., Branski, L. K., Gauglitz, G. G., Mlcak, R. P., & Herndon, D. N. (2008). Pathophysiologic response to severe burn injury. Annals of surgery, 248(3), 387–401.

    Article  Google Scholar 

  8. Tsiligianni, I., Kocks, J., Tzanakis, N., Siafakas, N., & van der Molen, T. (2011). Factors that influence disease-specific quality of life or health status in patients with COPD: a review and meta-analysis of Pearson correlations. Primary Care Respiratory Journal, 20(3), 257–268.

    Article  Google Scholar 

  9. Anselmi, P., Vidotto, G., Bettinardi, O., & Bertolotti, G. (2015). Measurement of change in health status with Rasch models. Health and Quality of Life Outcomes, 13, 16.

    Article  Google Scholar 

  10. Aghakhani, K., Abdolkarimi, L., Memarian, A., Hosseini, R., Mehrpisheh, S., Abdolkarimi, F., & Heidari, M. (2015). Epidemiology of occupational burn injuries and its effect on patients referred to Motahari Hospital in Tehran during 2010 to 2012. Razi Journal of Medical Sciences, 21(128), 66–71.

    Google Scholar 

  11. Rouzfarakh, M., Deldar, K., Froutan, R., Ahmadabadi, A., & Mazlom, S. R. (2021). The effect of rehabilitation education through social media on the quality of life in burn patients: a randomized, controlled, clinical trial. BMC Medical Informatics and Decision Making, 21(1), 70.

    Article  Google Scholar 

  12. Rennard, S. I. (1998). COPD: Overview of Definitions, Epidemiology, and Factors Influencing Its Development. Chest, 113(4, Supplement), 235S-241S.

  13. Collins, E. G., Langbein, W. E., Fehr, L., & Maloney, C. (2001). Breathing pattern retraining and exercise in persons with chronic obstructive pulmonary disease. AACN Advanced Critical Care, 12(2), 202–209.

    CAS  Google Scholar 

  14. Porter, C., Hardee, J. P., Herndon, D. N., & Suman, O. E. (2015). The role of exercise in the rehabilitation of patients with severe burns. Exercise and sport sciences reviews, 43(1), 34–40.

    Article  Google Scholar 

  15. Tang, D., Li-Tsang, C. W. P., Au, R. K. C., Li, K.-C., Yi, X.-F., Liao, L.-R., Cao, H.-Y., Feng, Y.-N., & Liu, C.-S. (2015). Functional outcomes of burn patients with or without rehabilitation in Mainland China. Hong Kong Journal of Occupational Therapy, 26(1), 15–23.

    Article  Google Scholar 

  16. Hancock, P., & Cox, K. (2008). Setting up a buddy scheme for pulmonary rehabilitation. Nursing times, 104(39), 31, 33.

  17. Maltais, F. o., Bourbeau, J., Shapiro, S., Lacasse, Y., Perrault, H. l. n., Baltzan, M., Hernandez, P., Rouleau, M., Julien, M., Parenteau, S., Paradis, B., Levy, R. D., Camp, P., Lecours, R., Audet, R., Hutton, B., Penrod, J. R., Picard, D., Bernard, S., & Chronic Obstructive Pulmonary Disease Axis of the Respiratory Health Network, F. d. l. r. e. s. d. Q. b. (2008). Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Annals of Internal Medicine, 149(12), 869–878.

    Article  Google Scholar 

  18. Bissett, B. M., Leditschke, I. A., Neeman, T., Boots, R., & Paratz, J. (2016). Inspiratory muscle training to enhance recovery from mechanical ventilation: a randomised trial. Thorax, 71(9), 812–819.

    Article  Google Scholar 

  19. Gosselink, R., De Vos, J., van den Heuvel, S. P., Segers, J., Decramer, M., & Kwakkel, G. (2011). Impact of inspiratory muscle training in patients with COPD: what is the evidence? European Respiratory Journal, 37(2), 416–425.

    Article  CAS  Google Scholar 

  20. Lin, S.-J., McElfresh, J., Hall, B., Bloom, R., & Farrell, K. (2012). Inspiratory muscle training in patients with heart failure: a systematic review. Cardiopulmonary physical therapy journal, 23(3), 29–36.

    Article  Google Scholar 

  21. Silva, I. S., Fregonezi, G. A. F., Dias, F. A. L., Ribeiro, C. T. D., Guerra, R. O., & Ferreira, G. M. H. (2013). Inspiratory muscle training for asthma. Cochrane Database of Systematic Reviews(9).

  22. Jenkinson, C. (1998). The SF-36 physical and mental health summary measures: an example of how to interpret scores. Journal of Health Services Research & Policy, 3(2), 92–96.

    Article  CAS  Google Scholar 

  23. Montazeri, A., Goshtasebi, A., Vahdaninia, M., & Gandek, B. (2005). The short form health survey (SF-36): translation and validation study of the Iranian version. Quality of Life Research, 14(3), 875–882.

    Article  Google Scholar 

  24. Beckerman, M., Magadle, R., Weiner, M., & Weiner, P. (2005). The effects of 1 year of specific inspiratory muscle training in patients with COPD. Chest, 128(5), 3177–3182.

    Article  Google Scholar 

  25. Charususin, N., Gosselink, R., Decramer, M., McConnell, A., Saey, D., Maltais, F., Derom, E., Vermeersch, S., van Helvoort, H., Heijdra, Y., Klaassen, M., Glöckl, R., Kenn, K., & Langer, D. (2013). Inspiratory muscle training protocol for patients with chronic obstructive pulmonary disease (IMTCO study): a multicentre randomised controlled trial. British Medical Journal Open, 3(8), e003101.

    Google Scholar 

  26. Zhou, L.-Q., Li, X.-Y., Li, Y., Guo, B.-P., Guan, L.-L., Chen, X., Luo, Y.-W., Luo, P., & Chen, R.-C. (2016). [Inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease: a randomized controlled trial] Nan fang yi ke da xue xue bao. Journal of Southern Medical University, 36(8), 1069–1074.

    PubMed  Google Scholar 

  27. Hulzebos, E. H. J., Helders, P. J. M., Favié, N. J., De Bie, R. A., Brutel de la Riviere, A., & Van Meeteren, N. L. U. (2006). Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing cabg surgery a randomized clinical trial. JAMA, 296(15), 1851–1857.

    Article  CAS  Google Scholar 

  28. Dipp, T., Macagnan, F. E., Schardong, J., Fernandes, R. O., Lemos, L. C., & Plentz, R. D. M. (2019). Short period of high-intensity inspiratory muscle training improves inspiratory muscle strength in patients with chronic kidney disease on hemodialysis: a randomized controlled trial. Brazilian. Journal of Physical Therapy, 24(3), 280–286.

    Article  Google Scholar 

  29. Bissett, B., Leditschke, I. A., Green, M., Marzano, V., Collins, S., & Van Haren, F. (2019). Inspiratory muscle training for intensive care patients: a multidisciplinary practical guide for clinicians. Australian Critical Care, 32(3), 249–255.

    Article  Google Scholar 

  30. Bakhshandeh, S., Najaf-Yarandi, A., Ahmadi, Z., & Hosseini, F. (2004). Respiratory exercises and the quality of lives of asthmatic patients. IJN, 17(38), 16–24.

    Google Scholar 

  31. Yekkefallah, L. (2006). The effect of physical exercise on the pulmonary function and quality of life in asthmatic patients. J Sabzevar School of Med Sci, 12(4), 14–19.

    Google Scholar 

Download references

Acknowledgements

The present study was derived from a thesis in master of nursing, Mashhad University of Medical Sciences, School of Nursing and Midwifery. The authors' deepest appreciation goes to all the patients involved in the study, the respected authorities of Imam Reza Hospital, research deputy of Mashhad University of Medical Sciences, and School of Nursing and Midwifery.

Funding

Research deputy of Mashhad University of Medical Sciences.

Author information

Authors and Affiliations

  1. School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

    Elahe Abazarnejad

  2. Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Razieh Froutan & Seyed Reza Mazlom

  3. Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

    Razieh Froutan & Seyed Reza Mazlom

  4. Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

    Ali Ahmadabadi

Authors
  1. Elahe Abazarnejad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Razieh Froutan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ali Ahmadabadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seyed Reza Mazlom
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RF, AAA, and SRM: Study conception and design; EA, RF, AAA: Data collection; EA, RF, and SRM: Data analysis and interpretation; EA, RF, AAA, and SRM: Drafting of the article, Critical revision of the article.

Corresponding author

Correspondence to Razieh Froutan.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

The present study obtained the approval of the Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.NURSE.REC.1397.086). Moreover, it was registered with the IRCT (IRCT.ir) code of IRCT20181225042110N1.

Consent to participate

The written informed consents were achieved and confidentiality of personal information was assured.

Consent for publication

The article does not contain any individual’s details and consent for publication is not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abazarnejad, E., Froutan, R., Ahmadabadi, A. et al. Improving respiratory muscle strength and health status in burn patients: a randomized controlled trial. Qual Life Res 31, 769–776 (2022). https://doi.org/10.1007/s11136-021-02996-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-021-02996-x

Keywords

Search

Navigation