Multi-axis shoulder abduction splint in acute burn rehabilitation: a randomized controlled pilot trial

Jang, Ki Un; Choi, Ji Soo; Mun, Jeong Hyeon; Jeon, Jong Hyun; Seo, Cheong Hoon; Kim, Jong Hyeon

doi:10.1177/0269215514547653

Cited by 13 publications

(6 citation statements)

References 16 publications

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“…2,4 Unfortunately, the reported efficacy has not been consistent, with contradictory results for scar massage 5,6 and splinting, for example. [7][8][9] However, in the early phase of scar remodelling during the first months after wound closure, fragility of scarred skin could limit the treatment options. Therefore, extracorporeal shock wave therapy (ESWT) is promising as a non-invasive type of physical intervention to treat scars.…”

Section: Introductionmentioning

confidence: 99%

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The effects of shock wave therapy applied on hypertrophic burn scars: a randomised controlled trial

Moortgat¹,

Anthonissen

Daele

et al. 2020

Scars, Burns & Healing

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Introduction: A wide variety of non-invasive treatments has been proposed for the management of hypertrophic burn scars. Unfortunately, the reported efficacy has not been consistent, and especially in the first three months after wound closure, fragility of the scarred skin limits the treatment options. Extracorporeal shock wave therapy (ESWT) is a new non-invasive type of mechanotherapy to treat wounds and scars. The aim of the present study was to examine the objective and subjective scar-related effects of ESWT on burn scars in the early remodelling phase. Material and methods: Evaluations included the Patient and Observer Scar Assessment Scale (POSAS) for scar quality, tri-stimulus colorimetry for redness, tewametry for trans-epidermal water loss (TEWL) and cutometry for elasticity. Patients were randomly assigned to one of two groups, the low-energy intervention group or the placebo control group, and were tested at baseline, after one, three and six months. All patients were treated with pressure garments, silicone and moisturisers. Both groups received the ESWT treatment (real or placebo) once a week for 10 weeks. Results: Results for 20 patients in each group after six months are presented. The objective assessments showed a statistically significant effect of ESWT compared with placebo on elasticity ( P = 0.011, η2 P=0.107) but revealed no significant effects on redness and TEWL. Results of the clinical assessments showed no significant interactions between intervention and time for the POSAS Patient and Observer scores. Conclusion: ESWT can give added value to the non-invasive treatment of hypertrophic scars, more specifically to improve elasticity when the treatment was already started in the first three months after wound closure. Lay Summary Pathological scarring is a common problem after a burn injury. A wide variety of non-invasive treatments has been proposed for the management of these scars. Unfortunately, the reported efficacy of these interventions has not been consistent, and especially in the first three months after wound closure, fragility of the scarred skin limits the treatment options. Extracorporeal shock wave therapy (ESWT) is a relatively new non-invasive therapy to treat both wounds and scars. The aim of the present study was to examine the scar-related effects of ESWT on burn scars in the early phase of healing. The scars were subjectively assessed for scar quality by the patient and an observer using the Patient and Observer Scar Assessment Scale (POSAS). Objective assessments included measurements to assess redness, water loss and elasticity. Forty patients were randomly assigned to one of two groups, the low-energy intervention group or the placebo control group (the device simulated the sound of an ESWT treatment but no real shocks were applied), and were tested at four timepoints up to six months. All patients were treated with pressure garments, silicone and moisturisers. Both groups received the ESWT treatment (real or placebo) once a week for 10 weeks. The objective assessments showed a significant improvement of elasticity in the intervention group when compared with placebo but revealed no significant effects on redness and water loss. Results of the clinical assessments showed no differences between the groups for the POSAS Patient and Observer scores. ESWT can give added value to the non-invasive treatment of pathological scars more specifically to improve elasticity in the early phase of healing.

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Section: Introductionmentioning

confidence: 99%

“…2,4 Unfortunately, the reported efficacy has not been consistent, with contradictory results for scar massage 5,6 and splinting, for example. 7–9…”

Section: Introductionmentioning

confidence: 99%

The effects of shock wave therapy applied on hypertrophic burn scars: a randomised controlled trial

Moortgat¹,

Anthonissen

Daele

et al. 2020

Scars, Burns & Healing

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“…Didesnė negu 90° peties sąnario padėtis nerekomenduojama dėl neigiamo po veikio peties rezginiui ar padidėjusio tempimo viršutinės galūnės periferiniams nervams [21]. K. U. Jangas su bendraautoriais [22] atliko tyrimą ir pritaikė gydymą padėtimi ir įtvarą peties sąnariui, kai žastas buvo atitrauktas 90°. Nustatyta, kad pacientų, kuriems buvo pritaikytas toks gydymas, judesių amplitudės peties sąnaryje rezultatai buvo geresni, palyginti su pacientais, kuriems taikyti tik pratimai.…”

Section: Gydymas Padėtimi Ir Nudegimų Traumaunclassified

“…Nustatyta, kad pacientų, kuriems buvo pritaikytas toks gydymas, judesių amplitudės peties sąnaryje rezultatai buvo geresni, palyginti su pacientais, kuriems taikyti tik pratimai. Tai pirmas iš nedaugelio atliktų tyrimų, kai gautas teigiamas judesių amplitudės rezultatas [22]. Taikant gydymą padėtimi, rekomen duojama atsižvelgti į rizikos ir naudos santykį [21].…”

Section: Gydymas Padėtimi Ir Nudegimų Traumaunclassified

Physiotherapy after Burns Injury, Acute and Surgical Burn Care Stages: Literature Review

Siparytė-Sinkevičienė

Rimdeika

2020

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People recovering from burn injury experience a wide range of challenges throughout their recovery. Currently, the survival is not the only important issue in the treatment of burns. As the advancement and amelioration in burn treatment have improved significantly, the patients’ recovery and abilities to return to their pre-burn functional status are of equal importance as well. The results of recent scientific literature review (Kazis et al.) demonstrate that 28% of burn survivors never return to any form of employment and only 37% of burn survivors regain the fullness of previous employment. Physical therapy is a critical, though painful, component of burn rehabilitation therapy and includes a variety of physiotherapy treatment methods such as exercise therapy, cardiopulmonary training, joint mobilization, positioning, splint adjustment, etc. The application of physiotherapy after burn injury was found to improve physical capacity, muscle strength, body composition, and quality of life. The use of early physiotherapy is also recommended in patients treated in the intensive care unit.

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“…All have reported short term results only, with the longest follow-up 12 weeks post hospital discharge. To date, two prospective RCTs, 76,77 a retrospective cohort study 50 and two prospective case series 78,79 have investigated outcomes of axilla splinting post burn. Mixed results have been reported, a RCT found no significant difference between subjects treated with and without an axilla splint, commencing on admission and continuing until 12 weeks postburn.…”

Section: Postburn Axilla Splinting Described In Literaturementioning

confidence: 99%

490 Outcomes of End of Range Axilla Splinting in Children Following Burn Injury

Thomas

Wicks

Toose

et al. 2019

Journal of Burn Care &Amp; Research

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Multi-axis shoulder abduction splint in acute burn rehabilitation: a randomized controlled pilot trial

Abstract: The new multi-axis shoulder abduction splint resulted in a significant improvement in shoulder abduction angle compared to unsplinted patients.

Cited by 13 publications

References 16 publications

The effects of shock wave therapy applied on hypertrophic burn scars: a randomised controlled trial

The effects of shock wave therapy applied on hypertrophic burn scars: a randomised controlled trial

Physiotherapy after Burns Injury, Acute and Surgical Burn Care Stages: Literature Review

490 Outcomes of End of Range Axilla Splinting in Children Following Burn Injury

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