This study will be conducted to investigate the effect of early multi-angle isometric exercise on muscle properties in post-burn patients.
A burn injury represents the fourth most common type of trauma globally, though it is associated with the most devastating consequences Severe burn injuries, encompassing ≥20% of the total body surface area (TBSA) in adults, present a unique challenge compared with other forms of trauma given the magnitude and persistence of systemic dysregulation.Burns can occur when the skin is exposed to heat sources, such as flames, flash burns, hot objects, grease, scald, chemicals, and electricity Burn injuries are highly variable, as is their severity. The patient's comorbidities can influence the burn's clinical outcome. Additionally, morbidity and mortality tend to increase as the surface area of the burn increases .Isometric exercise is a static form of exercise in which a muscle contracts and produces force without an appreciable change in the length of the muscle and without visible joint motion. Although there is no mechanical work done (force × distance), a measurable amount of tension and force output are produced by the muscle. Sources of resistance for isometric exercise include holding against a force applied manually, holding a weight in a particular position, maintaining a position against the resistance of body weight, or pushing or pulling an immovable object.Although post-burn muscle wasting is widely recognized, it is not consistently targeted as a primary rehabilitation outcome during the acute phase of care. Furthermore, there is a lack of randomized controlled trials examining the effects of early Multi- angle isometric exercise on objective measures of muscle mechanical properties in acute burn patients using sensitive technology like the MyotonPRO.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
isometric exercises targeting the affected muscle groups Lower limb muscles. Exercises will begin within the first week post-burn after medical stabilization, Isometric contractions will be performed at submaximal intensity (approximately 50-60% of maximum voluntary contraction).Each contraction will be held for 5-10 seconds followed by 10 seconds of relaxation. Each muscle group will perform 10 repetitions per set in addition to conventional physical therapy
Conventional physical therapy programs include positioning, mobilization, range of motion exercises, stretching and splinting
muscle dynamic stiffness
The MyotonPro (Myoton AS Tallinn, Estonia) device will be used to assess muscle dynamic stiffness. it introduces an innovative and non-invasive approach for comprehensively characterizing the biomechanical and viscoelastic properties of muscles.The device is applied under constant preload (0.18 N) to pre-compress subcutaneous tissues, and it exerts a brief (15 milliseconds) mechanical tap at a pre-determined force (0.4 Newtons), followed by quick release, causing damped oscillations that are recorded by the testing probe. This device is portable, inexpensive, easy to use, and convenient for re-cording the biomechanical and viscoelastic stiffness of myofascial tissues relatively quickly.A higher dynamic stiffness indicates greater resistance to force application.
Time frame: up to 3 weeks
lower limb disability
The Lower Extremity Functional Scale (LEFS) is a patient-reported outcome measure which assesses the functional status of patients who have lower extremity conditions of musculoskeletal origin. The 20-item questionnaire inquires as to the degree of difficulty of performance of each of these activities on a 5-point Likert scale and a score of 80 represents an individula with normal functions
Time frame: up to 3 weeks
oscillatory frequency
The MyotonPro (Myoton AS Tallinn, Estonia) device will be used to assess oscillation frequency. it introduces an innovative and non-invasive approach for comprehensively characterizing the biomechanical and viscoelastic properties of muscles.The device is applied under constant preload (0.18 N) to pre-compress subcutaneous tissues, and it exerts a brief (15 milliseconds) mechanical tap at a pre-determined force (0.4 Newtons), followed by quick release, causing damped oscillations that are recorded by the testing probe. This device is portable, inexpensive, easy to use, and convenient for re-cording the biomechanical and viscoelastic stiffness of myofascial tissues relatively quickly.A higher oscillation frequency indicates higher muscle tone, while increased stiffness reflects greater resistance to force application.
Time frame: up to 3 weeks
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muscle elasticity
the MyotonPro (Myoton AS Tallinn, Estonia) device will be used to assess muscle elasticity. it quantifies the dissipation of mechanical energy (damping) during natural oscillations of a muscle. lower values signify higher elasticity (i.e., better ability to recover from deformation), while higher values suggest lower elasticity.
Time frame: up to 3 weeks