Refining the Idiom “Functional Range of Motion” Related to Burn Recovery

Korp, Katie; Richard, Reg; Hawkins, Donald E.

doi:10.1097/bcr.0000000000000149

Cited by 30 publications

(24 citation statements)

References 46 publications

(41 reference statements)

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“…However, a standard classification scale or system to interpret the degree of joint limitation is not available in burn care. Therefore, the general interpretation of degree of limitation has a variable subjectivity or is classified by own description-and rating classification systems [32,33]. Korps found seven studies which classified the degree of limitation of a burn scar contracture.…”

Section: Discussionmentioning

confidence: 99%

The degree of joint range of motion limitations after burn injuries during recovery

Schouten

Nieuwenhuis

Baar

et al. 2022

Burns

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Section: Discussionmentioning

confidence: 99%

The degree of joint range of motion limitations after burn injuries during recovery

Schouten

Nieuwenhuis

Baar

et al. 2022

Burns

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“…Decreased ROM of joints in the lower limb restricts overall mobility and knee contractures limit ambulation, increase energy expenditure, increase the risk of falls, and increase wear on more other joints such as the hip, lumbar spine, and contralateral knee 10,15‐17 . Like OA, knee FC contributes to pain and stiffness and interferes with daily activities 15,18‐21 …”

Section: Introductionmentioning

confidence: 99%

Knee Flexion Contractures Are Associated with Worse Pain, Stiffness, and Function in Patients with Knee Osteoarthritis: Data from the Osteoarthritis Initiative

Campbell

Ramsay

Trudel

2020

PM&R

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Background Patients with or at risk of developing knee osteoarthritis (OA) can acquire a knee flexion contracture (FC). The prevalence, severity, and association of knee FC on OA outcomes such as pain, stiffness, and function are not well described and clinical scales may omit measuring joint range of motion. Objective (1) To determine if the presence and severity of a knee FC was associated with worse joint pain, stiffness and/or function and (2) to determine if this association was present in participants with or at risk of knee OA. Methods Following a detailed standardized protocol, maximum knee extension was obtained from the baseline physical examination data using a goniometer with the fulcrum over the knee joint line, the upper arm directed towards the greater trochanter and the lower arm directed towards the lateral malleolus. Design Cross‐sectional, using the Osteoarthritis Initiative database. Setting and Participants Baseline cross‐sectional data collected from a prospective outpatient cohort study, recruiting from four academic health care centers in the United States. Three subcohorts were included: those at‐risk of OA (n = 5995 knees), those with radiographic OA (n = 2610 knees), and controls (n = 62 knees). Main Outcome Measures We categorized knee FCs as none, mild, moderate, or severe. Pain scales included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and numeric pain rating scale; stiffness, the WOMAC stiffness subscale; and function, the WOMAC function subscale and 400‐m walk time. Results Participants with FC reported overall worse pain, stiffness, and function compared to those without FC in a severity‐dependent manner. OA participants' scores showed between 1.8‐ and 11.0‐fold mean relative worsening versus at‐risk participants (P < .05 for all). Knee FC was independently associated in a severity‐dependent manner with all outcomes (P < .01). Conclusions Knee FCs were associated with worse pain, stiffness, and function in a severity‐dependent manner in a population with or at risk of knee OA. There was an interaction between OA subcohort and FC severity (P‐for‐interaction <.01 for all WOMAC outcomes). Evaluation of the longitudinal effects of contracture on OA and at‐risk patient outcomes is necessary.

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“…Usually, traditional rehabilitation interventions in mainland China are provided after most wound areas are healed. In contrast, early rehabilitation in burn patients showed improvement in joint ROM and a shorter BICU LOS and in the hospital [27–29]. According to the analysis in this study, we found that when early rehabilitation was performed within 7 days post-injury, severe burn patients could have fewer contractures of decreased severity.…”

Section: Discussionmentioning

confidence: 77%

Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care unit in China: a descriptive analysis

et al. 2019

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Background Joint contracture is the major clinical complication in burn patients, especially, the severe burn patients. This study aimed to investigate the number and severity of joint contractures in patients with burns affecting greater than or equal to 50% of the total body surface area (TBSA) undergoing early rehabilitation in a burn intensive care unit (BICU). Methods We analyzed burn patients with burns affecting greater than or equal to 50% of the TBSA admitted to a BICU who received early rehabilitation within 7 days post-injury from January 2011 to December 2015. Demographic and medical information was collected. The range of motion (ROM) of different joints was measured 1 month post-admission. Spearman’s correlation coefficient and logistic regression analysis was used to determine predictors of the presence and severity of contractures. Result The average affected TBSA of the included burn patients was 67.4%, and the average length of stay in the BICU was 46.2 ± 28.8 days. One hundred and one of 108 burn patients (93.5%) developed at least one joint contracture. The ROM in 67.9% of the affected joints was mildly limited. The majority of contractures in severe burn patients were mild (37.7%) or moderate (33.2%). The wrist was the most commonly affected joint (18.2%), followed by the shoulder, ankle, hip, knee, and elbow. A predictor of the presence of contractures was the length of hospital stay (p = 0.049). The severe contracture was related to the area of full-thickness burns, the strict bed rest time, and the duration of rehabilitation in BICU. The length of rehabilitation stay (days) in patients with moderate contracture is 54.5% longer than that in severe contracture (p = 0.024) Conclusion During the long stay in BICU, the length of rehabilitation stay in a BICU could decrease the severity of contractures from severe to moderate in the patients with equal to 50% of the TBSA. Hence, this research reveals the important role of early rehabilitation interventions in severe burn patients.

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Refining the Idiom “Functional Range of Motion” Related to Burn Recovery

Cited by 30 publications

References 46 publications

The degree of joint range of motion limitations after burn injuries during recovery

The degree of joint range of motion limitations after burn injuries during recovery

Knee Flexion Contractures Are Associated with Worse Pain, Stiffness, and Function in Patients with Knee Osteoarthritis: Data from the Osteoarthritis Initiative

Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care unit in China: a descriptive analysis

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