Effects of early rehabilitation in improvement of paediatric burnt hands function

Rehabilitation Frequency for Pediatric Patients With Burns in Acute Care

It is known that rehabilitation provides beneficial outcomes postburns. However, the frequency of therapy interventions is inconsistent, especially in the hospital setting. Our objective is to identify the frequency of rehabilitation interventions for pediatric patients with burns in acute care. Manuscripts were included if they addressed rehabilitation burn interventions for the pediatric population and reported intervention frequencies. Studies were excluded if they included adults and/or were beyond the acute care setting. We searched 6 databases for published literature, in the English language, from 2010 to April 2023. A total of 140 articles were found; however, only 8 met the inclusion criteria. Five studies met criteria for high-quality evidence, 3 for low quality. Frequency of rehabilitative therapy in the acute care setting was found to be variable, ranging from 1 day per week to 2 times per day. More research is needed to support optimum frequency.

Effect of augmented reality-based rehabilitation of hand burns on hand function in children: A randomized controlled trial

BACKGROUND

Despite the use of traditional rehabilitation methods, hand function may still remain impaired in children suffering from burn injuries.

PURPOSE

This study aimed to assess the impact of implementing an augmented reality (AR) rehabilitation booklet designed for pediatric hand burn on their hand functionality.

STUDY DESIGN

This was a randomized controlled trial.

METHODS

Seventy-two children, aged 8-14 years with a hand burn, were randomly allocated into intervention (n = 36) and control (n = 36) groups. Children in the control group received routine rehabilitation program, while in the intervention group, children performed exercises using a printed booklet with related AR application. The Jebsen-Taylor Hand Function Test was completed before the intervention at the time of the patients' discharge and 1 month later.

RESULTS

The results of analysis of covariance based on baseline- and fully-adjusted models showed significant intervention effect after discharge as well as after intervention for hand function (mean difference [95% confidence interval] for discharge: -8.2 [-15.0 to -1.4] and for after intervention: -74.0 [-88.8 to -59.1]) and the items (all p < 0.05), except for writing and lifting large light objects for both after discharge and after intervention measures (all p-value > 0.05).

CONCLUSIONS

A significant decrease in the total time taking to complete the Jebsen-Taylor hand function test was observed in the intervention group compared to the control group 1 month after discharge. Rehabilitation of children with hand burns, using printed educational booklet with related AR application, improves their hand function.

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

Objective

This study aims to explore the clinical effect of early rehabilitation training combined with negative pressure wound therapy (NPWT) for treating deep partial-thickness hand burns.

Methods

Twenty patients with deep partial-thickness hand burns were randomly divided into an experimental group (n = 10) and a control group (n = 10). In the experimental group, early rehabilitation training combined with NPWT was performed, including the proper sealing of the negative pressure device, intraoperative plastic brace, early postoperative exercise therapy during negative pressure treatment, and intraoperative and postoperative body positioning. Routine NPWT was conducted in the control group. Both groups received 4 weeks of rehabilitation after wounds healed by NPWT with or without skin grafts. Hand function was evaluated after wound healing and 4 weeks after rehabilitation, including hand joint total active motion (TAM) and the brief Michigan Hand Questionnaire (bMHQ).

Results

Twenty patients were involved in this study, including 16 men and 4 women, aged 18-70 years, and the hand burn area ranged from 0.5% to 2% of the total body surface area (TBSA). There was no significant difference in TAM and bMHQ scores between the two groups after negative pressure removal. After 4 weeks of rehabilitation training, the TAM scores and bMHQ scores were significantly improved in both groups (p < 0.05); among them, those of the experimental group were both significantly better than those of the control group (p < 0.05).

Conclusion

The application of early rehabilitation training combined with NPWT to treat deep partial-thickness hand burns can effectively improve hand function.