Effects of early rehabilitation in improvement of paediatric burnt hands function

Abstract

BACKGROUND Hands are one of the most common burn sites in children. Hypertrophic scar contractures in hands after wound healing result in further reductions in their range of motion (ROM), motility, and fine motor activities. Rehabilitation can improve the function of hands. But the optimal time of rehabilitation intervention is still unclear. Therefore, this study was designed to investigate the effects of early rehabilitation management of paediatric burnt hands and to compare the efficacy between early and later rehabilitation intervention. AIM To investigate the effects of early rehabilitation management of paediatric burnt hands. METHODS A total of 52 children with burnt hands were allocated into the early intervention group (≤ 1 mo from onset) and a late intervention group (> 1 mo from onset) between January 2016 and December 2017. The children received the same rehabilitation programme including skin care, scar massage, passive ROM exercises, active ROM exercises, compression therapy, orthotic devices wearing and game or music therapy. Rehabilitation assessments were performed before and after the rehabilitation treatment. RESULTS In the early intervention group, the ROM of the hands was significantly improved after rehabilitation ( P = 0.001). But in the late group the effect was not significant statistically ( P = 0.142). In the early group, 38.5% of the patients showed significant improvement, while in the late group, 69.2% of the patients showed no significant improvement. The time from onset to posttraumatic rehabilitation ( P = 0.0007) and length of hospital stay ( P = 0.003) were negatively correlated with the hand function improvement. The length of rehabilitation stay was positively correlated with the hand function improvement ( P = 0.005). CONCLUSION These findings suggest that early rehabilitation might show better results in terms of ROM.

Clinical study of early rehabilitation training combined with negative pressure wound therapy for the treatment of deep partial-thickness hand burns

“…Clinical practice has shown that early application of braces to maintain body position and prevent scar contraction can reduce obvious joint deformities, and the recovery of joint function is obviously better than that of patients who started treatment late, only after joint contraction appeared (30)(31)(32). We attempted to assist hand positioning with braces during the NPWT process, even using a thin and low-temperature thermoplastic material (which can be appropriately placed in shape under negative pressure) to maintain thumb abduction and a functional hand position.…”

Intervención fisioterapéutica en pacientes con quemaduras, una revisión narrativa

“…La rehabilitación de las quemaduras durante la etapa aguda debe centrarse en la reducción del edema de la herida, el mantenimiento de la posición anti-contractura y los ejercicios en rango de movimiento pasivo asistido por el fisioterapeuta y rango de movimiento activo ejecutados únicamente por el paciente, pero bajo la supervisión del fisioterapeuta (23).…”