Research David Schieffelers

Abstract

Severe burns cause a cascade of unwanted effects such as an overdrive in metabolism, loss of muscle tissue, and loss of the body's ability to effectively handle glucose as an energy source and an enhanced inflammatory state. Against common belief, these side effects have shown to persist for years, and cause long-term consequences such as a reduced physical fitness and a higher risk of developing diabetes. Despite many research efforts, much of these persistent side effects that occur in burns are not well understood. Efforts to counteract the negative effects on metabolism, the loss of muscle tissue and to prevent or lessen the amount of the inflammation have not yet been successful. Exercise rehabilitation has the potential to, at least partly, prevent and/or restore the negative consequences as has been shown in other critically ill hospitalised patients. This project will, therefore, shed more light onto 1) the short- and long-term effects of severe burns on energy metabolism, loss of muscle tissue, and inflammation in adults, and 2) the effect of an 8-week exercise rehabilitation programme during the initial period of hospitalization on these parameters. In order to successfully execute this project, we will study patients from Belgium and Chinese burn centres to get a better understanding of the bodily derangements, which will lay a foundation for better future care of burn patients.

Researcher(s)

• Promoter: Van Daele Ulrike
• Co-promoter: van Breda Eric
• Fellow: Schieffelers David

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Severe burns cause a cascade of unwanted effects such as an overdrive in metabolism, loss of muscle tissue, and loss of the body's ability to effectively handle glucose as an energy source and an enhanced inflammatory state. Against common belief, these side effects have shown to persist for years, and cause long-term consequences such as a reduced physical fitness and a higher risk of developing diabetes. Despite many research efforts, much of these persistent side effects that occur in burns are not well understood. Efforts to counteract the negative effects on metabolism, the loss of muscle tissue and to prevent or lessen the amount of the inflammation have not yet been successful. Exercise rehabilitation has the potential to, at least partly, prevent and/or restore the negative consequences as has been shown in other critically ill hospitalised patients. This project will, therefore, shed more light onto 1) the short- and long-term effects of severe burns on energy metabolism, loss of muscle tissue, and inflammation in adults, and 2) the effect of an 8-week exercise rehabilitation programme during the initial period of hospitalization on these parameters. In order to successfully execute this project, we will study patients from Belgium and Chinese burn centres to get a better understanding of the bodily derangements, which will lay a foundation for better future care of burn patients.

Researcher(s)

• Promoter: Van Daele Ulrike
• Co-promoter: van Breda Eric
• Fellow: Schieffelers David

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project

Abstract

Severe burned patients undergo rapid increases in metabolism (hypermetabolism) and increased energy expenditure caused by the initial inflammatory and humoral responses. These responses also elicit, on top of the bed rest period, a cascade of negative reactions leading to additional muscle wasting. Muscle wasting itself leads to insulin resistance and may have long-term health consequences. Some of these effects persist from the first few days following severe burn injury to as long as three years later after wound closing. Although insulin resistance is assumed to be triggered by several catabolic factors, an important contributor to insulin resistance is muscle wasting itself. Insulin-resistance, may eventually lead to diabetes mellitus and is a long-term complication of severe burn patients which has major implications for future morbidity and mortality. Physical exercise has been shown to affects both the metabolism as well as skeletal muscle function in oncology, cardiac patients, obstructive lung diseases and diabetic patients. In addition, physical exercise in critically-ill patients has also been shown to have beneficial effects on general health outcome parameters. Therefore, in the present study we will investigate the effects of severe burns [≥ 30 % total body surface area (TBSA)] on energy expenditure, hypermetabolism (especially insulin and glucose homeostasis) and muscle function (strength). Besides the fundamental research questions we will investigate the effect of an 8 week (3 times/week) rehabilitative exercise strength training on energy expenditure, hyper metabolism and muscle function. For the long-term effects we will investigate the Quality of Life (QoL) in patients undergoing such an additional rehabilitative program on top of standard-care. For this purpose we will use both general as well as burn specific questionnaires regarding QoL.

Researcher(s)

• Promoter: Van Daele Ulrike
• Co-promoter: Gebruers Nick
• Co-promoter: van Breda Eric
• Fellow: Schieffelers David

Research team(s)

• Movement Antwerp (MOVANT)

Project type(s)

• Research Project