Effect of Physiotherapy Protocol on Post Burn Upper Limbs' Function

Abstract

Introduction: Burns of the hand have devastating consequences not only for the functional outcome but also for the esthetic appearance. Post burn functional disabilities of the upper extremity are better prevented than treated. Aim: this study aimed to evaluate the effect of physiotherapy protocol on upper limbs' function post burn. Design: A quasi-experimental (time series) design submitted to meet the aim of the study. Subjects: A purposive sample of 27 male and female adult patients with 2 nd degree burn in hand assigned in the current study which was carried out in Burn Department and its outpatient clinic of General hospital at Minia city. Tools: Four tools were utilized to collect data of this study; demographic questionnaire, Disabilities of the Arm, Shoulder and Hand Scale (DASH), Manual Muscle testing, and Vancouver Scar Assessment Scale (VSS). Results: Twenty seven adult 2 nd degree burned patients with mean age 36.0 ± 11.22 are included in the study. Gradual improvement of the upper limbs' function measured through DASH scale was observed after application of physiotherapy protocol, this appear through significant decrease in complain from severe dysfunction among 25.9% after 2 months to 0% after 6 months; significant increase in muscle force (22.2%, 59.3%) and prominent improvement of burn scar measured by VSS. Conclusions: The data suggest that the upper limbs' function post burns can be improved by preventive nursing interventions including early range of motion, anti-contracture positioning and splinting of hand which has positive effects on burn scar. Recommendations: regular training programs to keep nurses in burn units updated with the evidence-based practices and array interventions for reducing burn scar and improving limbs' function and therefore patients' productivity.

Surgical Management of Post Burn Hand Deformities

“…In a previous study by Mohammed H et al 27 adult 2nd degree burned patients showed gradual improvement of the upper limbs' function measured through DASH scale after application of physiotherapy protocol, this appear through significant decrease in complain from severe dysfunction among 25.9% after 2 months to 0% after 6 months. 16 These findings highlight that the upper limbs' function post burns could be improved by preventive nursing interventions including early range of motion, anti-contracture positioning and splinting of hand. 16 We also noted that children aged 6-12 years and adolescents aged 13-18 years showed satisfactory outcomes of surgical procedures as compared to adults aged more than 18 years.…”

“…16 These findings highlight that the upper limbs' function post burns could be improved by preventive nursing interventions including early range of motion, anti-contracture positioning and splinting of hand. 16 We also noted that children aged 6-12 years and adolescents aged 13-18 years showed satisfactory outcomes of surgical procedures as compared to adults aged more than 18 years. In children contractures released were better resurfaced with full thickness skin grafts due to reduced secondary contraction compared with split thickness skin grafts.…”