Effects of aerobic, resistance, and combined exercise training on coagulation and fibrinolytic activity in major burns: a preliminary randomized trial

Abstract Background This study aimed to compare the effects of different exercise protocols—resistance, aerobic, and combined resistance-aerobic training—on coagulation and fibrinolytic activity in major burns. Methods This prospective, randomized study included 30 major burn patients who were divided into three intervention groups: resistance exercise (Group 1, n = 10), aerobic exercise (Group 2, n = 10), and combined resistance-aerobic exercise (Group 3, n = 10). Each group underwent a six-week supervised exercise program in addition to standard medical treatment. Coagulation and fibrinolytic markers were measured at baseline and weekly. Statistical analyses were conducted using Shapiro–Wilk test for normality, one-way ANOVA or Kruskal–Wallis for between-group comparisons, and Friedman/BONFERRONI post-hoc analysis for within-group comparisons. Results The D-dimer and ferritin levels significantly decreased in Group 3 compared to baseline and other groups (p < 0.05). While fibrinogen levels remained stable in Group 3, Groups 1 and 2 showed a significant decline over time (p < 0.05). No significant intergroup differences were observed in PT and APTT values (p > 0.05), indicating that none of the interventions induced abnormal coagulation. Conclusions Exercise interventions, particularly combined resistance and aerobic training, appear to positively influence coagulation and fibrinolysis in burn patients. These findings suggest that an integrated exercise regimen may support recovery by modulating hypercoagulability and systemic inflammation. Further large-scale studies are warranted to confirm these results and to assess the long-term effects of exercise on coagulation dynamics in burn rehabilitation. Trial registration: Trial registration date: 17/04/2022, trial registration number: NCT05341674 “Prospectively registered”.