Investigation of the effect of exercise protocol determined according to metabolic rate in early burn patients on coagulation, fibrinolytic activity and functional capacity

This study was conducted to investigate the effect of exercise protocol determined according to metabolic rate on coagulation, fibrinolytic activity and functional capacity in patients with early burns. A total of 25 patients hospitalized in the Burn Center, service and intensive care unit were included in the study. The patients were divided into 3 groups as 1-standard care, 2-standard care + aerobic training group, 3-standard care + exercise protocol determined according to metabolic rate by stratified randomization method. Individuals were evaluated weekly for 6 weeks from the first day of hospitalization. D-Dimer, fibrinogen, platelet ferritin, prothrombin time (PT), activated partial thromboplastin time (APTT) biochemical parameters were used to evaluate coagulation and fibrinolytic activity, while 6-minute walking test (6DYT), physiological consumption index (FTİ) and MRC muscle strength measurements were used to evaluate functional capacity. Portable indirect calorimeter was used to measure the metabolic rates of all patients. It was observed that the aerobic exercises given in addition to the standard physiotherapy protocol and the physiotherapy protocol created according to the metabolic rate were more effective on functional capacity, coagulation and fibrinolytic activity compared to standard physiotherapy (p<0.05). Improvement in functional capacity, normalization of coagulation and fibrinolytic activity were faster in patients in the new physiotherapy protocol based on metabolic rate compared to the two groups (p<0.05). In our study, when the d-dimer values were evaluated in all groups, it was seen that the weekly recovery rate of the d-dimer values of the individuals in the 3rd group was better than the other groups, and the number of patients who reached the reference values was higher (p<0.05). It was concluded that the effects of endothelial damage, tissue hypoperfusion and hypothermia that occur immediately after trauma can be minimized by exercise, and thus the incidence of coagulopathy seen after burns can be reduced. It was determined that metabolic rate should also be taken into account when planning exercise in burn patients. There is a need for new studies on this subject