Resistance exercise and insulin resistance post burn

Background: Insulin resistance is an increasing health problem, causing functional disability in large populations. Burn can trigger a hyper metabolic state that is associated with insulin resistance and hyperglycemia. The initial and later stages of hyperinsulinemia pathogenesis, peripheral tissues remain abnormally insensitive to the anabolic effects of insulin due to changes at the cellular level. In addition to losing the beneficial anabolic effects of insulin, IR diminishes the ability of insulin to promote mitogenic, and cytoprotective functions. The pathophysiological processes involved must therefore involve abnormal signaling at the insulin receptor level or through post-receptor intracellular changes, resulting in increased circulating glucose, which is further worsened by inappropriate hepatic gluconeogenesis which is triggered by stress like burn. Purpose: This study aimed to investigate the effect of resistance exercise on insulin resistance post-burn. Material and Methods: A randomized, controlled, clinical trial enrolled 68 patients diagnosed with insulin resistance post burn, aged 18-35 years. Participants were randomly assigned into two groups (n=34/group): Group A: patients received resistance exercise using sand bags, resistance machines and elastic bands for twelve weeks, three times/ week, and session 30 in addition to routine medical treatment (Omege-3 polyunsaturated fatty acids, vitamin B complex and protein rich diet); group B: patients received routine medical treatment only. Insulin resistance was assessed using HOMA-IR. Results: There was a significant decrease of HOMA IR scores in group A by percentage of 27%, also there was a statistically significant difference between the two groups in favor of group A after treatment (after 12 weeks) (p< 0.05). Conclusion: Resistance exercise has an effect on insulin resistance post-burn represented by improvement of insulin resistance measured by HOMA IR test.