Effects of Balance, Plyometric, and Combined Plyometric-Balance Training in Pediatric Burn Survivors

Qassim University84 enrolled

Overview

Children who sustain burn injuries often develop long-term physical and psychological complications that limit their ability to move, exercise, and participate in daily activities. These problems commonly include reduced balance, muscle weakness, fatigue, and impaired physical performance, which may persist for several years after injury and require prolonged rehabilitation. This study aims to investigate the effects of three different exercise-based rehabilitation programs-balance training, plyometric (jump-based) training, and a combined balance and plyometric training program-on balance and physical performance in children recovering from burn injuries. A total of 84 children aged 10 to 17 years with healed lower-limb burns will be randomly assigned to one of the three training groups. Each group will participate in supervised exercise sessions three times per week for eight weeks. Balance, muscle strength, power, and agility will be assessed before and after the training period using standardized physical performance tests. The findings of this study are expected to help identify the most effective rehabilitation approach for improving functional abilities and physical performance in pediatric burn survivors during long-term recovery.

Burn injuries in children are frequently associated with long-lasting impairments in balance, muscle strength, coordination, and physical performance. These limitations may persist long after wound healing due to sensory disturbances, muscle wasting, fatigue, prolonged inactivity, and reduced physical activity levels. Such functional deficits can restrict participation in daily activities and negatively influence long-term recovery, emphasizing the need for effective rehabilitation strategies. This randomized, single-blind, parallel-group clinical trial is designed to evaluate and compare the effects of three different rehabilitation training programs on balance and physical performance in pediatric burn survivors. Eighty-four children aged between 10 and 17 years with healed burn injuries affecting more than 30% of total body surface area and involving the lower extremities will be recruited. All participants will be at least one year post-injury and medically stable. Following baseline assessments, participants will be randomly allocated to one of three intervention groups: balance training, plyometric training, or combined plyometric and balance training. Each group will undergo supervised exercise sessions three times per week for a total duration of eight weeks. All training sessions will begin with a standardized warm-up to ensure consistency across groups. Outcome assessments will be conducted before and after the training period to evaluate changes in static and dynamic balance, lower-limb muscle strength, muscular power, and agility using standardized and validated physical performance tests.

Interventions

Plyometric Exercise Training ProgramOTHER

This intervention consists of a structured plyometric exercise program delivered over eight weeks, with three supervised sessions per week on non-consecutive days. The program focuses on lower-extremity jumping and explosive movements designed to enhance neuromuscular performance, power, and coordination. Exercises emphasize proper posture, controlled landings, minimal ground contact time, and rapid stretch-shortening cycle actions. Training intensity and complexity progressively increase throughout the intervention period. Each session begins with a standardized warm-up.

Balance Training ProgramOTHER

This intervention consists of an eight-week supervised balance training program conducted three times per week on non-consecutive days. The program includes progressive static and dynamic stabilization exercises aimed at improving postural control, coordination, and balance performance. Exercise difficulty is gradually increased based on participant progression to provide appropriate challenge. Each training session begins with a standardized warm-up.

Combined Plyometric and Balance Training ProgramOTHER

This intervention integrates balance and plyometric exercises within a single training session over an eight-week period, with three supervised sessions per week. Approximately half of each session focuses on balance exercises performed using slow, controlled movements, followed by plyometric exercises emphasizing rapid stretch-shortening cycle actions. Training progression involves gradual increases in exercise intensity, complexity, repetitions, and sets. Each session begins with a standardized warm-up. Total training volume and frequency are matched to those of the single-modality training groups.

Eligibility

Sex: ALLMin age: 10 YearsMax age: 17 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Children aged 10 to 17 years. * History of burn injury involving more than 30% of total body surface area (TBSA). * Burn injury involving the lower extremities. * At least one year has elapsed since the burn injury. * Completion of acute medical management and participation in outpatient rehabilitation programs. * Medically stable and able to participate in supervised exercise training. * Written informed consent provided by parents or legal guardians. Exclusion Criteria: * Presence of unhealed or open burn wounds. * Any neurological disorder, unrelated to burn injury. * Any musculoskeletal disorder, unrelated to burn injury. * Any orthopedic disorder that may interfere with exercise participation or outcome assessment.

Outcomes

Primary Outcomes

Static Balance Performance (Standing Stork Test)

Static balance will be evaluated using the Standing Stork Test.

Time frame: Baseline (pre-intervention)

Static Balance Performance (Standing Stork Test)

Static balance will be evaluated using the Standing Stork Test.