Hand Burn
Conditions
Brief summary
No study has investigated the effect of extracorporeal shock wave therapy (ESWT) on hand function and hypertrophic scar characteristics. To investigate ESWT effects on burned hands, the investigators compare the results of ESWT combined with manual therapy group to the results of matched conventional(CON) rehabilitation combined with manual therapy group.
Detailed description
Hands are the most frequent injury sites caused by burn, and appropriate rehabilitation is essential to ensure that good functional recovery is achieved. In burn patients, the wound healing process may lead to a fibrotic hypertrophic scar, which is raised, red, inflexible and responsible functional and cosmetic impairments. This randomized, controlled trial involved 40 patients with burns and dominant right-hand function impairment. Patients were randomized into a ESWT or a CON group. Each intervention was applied to the affected hand for 4 weeks once per week. Hand function was evaluated using the Jebsen-Taylor hand function test (JTT), grasp and pinch power test, and Michigan Hand Outcomes Questionnaire (MHQ). These assessments were evaluated pre-intervention and 4 weeks post-intervention.
Interventions
OTHERExtracorporeal shock wave therapy
ESWT was conducted using the Duolith SD-1® device (StorzMedical, Tägerwilen,Switzerland) with an electromagnetic cylindrical coil source for the focused shock wave. ESWT was performed around the primary treatment site at 100 impulses/cm2, an energy flux density(EFD) of 0.05 to 0.30 mJ/mm2, frequency of 4Hz, and 1000 to 2000 impulses were administered at 1-week intervals for 4 sessions.
Sponsors
Hallym University
Hangang Sacred Heart Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
The patients' burn scars had re-epithelialized after aseptic care or skin graft. We included patients aged ≥18 years with a deep partial-thickness (second-degree) burn or a full thickness (third-degree) burn to their hands, with joint contracture(hand and wrist), having been transferred to the rehabilitation department after acute burn treatment, and less than 6 months since the onset of the burn injury. Selected patients had a history of hand surgery resulting in painful, retracting scarring on hands.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* a deep partial-thickness (second-degree) burn or a full thickness (third-degree) burn to their hands * less than 6 months since the onset of the burn injury
Exclusion criteria
* fourth-degree burns(involving muscles, tendons, and bone injuries)\\ * musculoskeletal diseases(fracture, amputation, rheumatoid arthritis, and degenerative joint diseases) in the burned hands * neurological diseases(such as peripheral nerve disorders) * preexisting physical and psychologic disability (severe aphasia and cognitive impairment that could influence the intervention) * severe pain impeding hand rehabilitation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| melanin and erythema | 4 weeks | measure melanin levels and the severity of erythema. The higher values indicating a darker and redder skin(AU) |
| sebum | 4 weeks | the severity of greese, the higher values indicating a more greese(mg/cm2) |
| elasticity | 4 weeks | The numeric values (mm) of the skin's distortion is presented as the elasticity. |
| thickness | 4 weeks | scar thickness(cm) |
| transepithelial water loss | 4 weeks | the degree of water evaporation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Jebsen-Taylor hand function test | 4 weeks | The JTT measure the performance speed of standardized tasks. The JTT involves a series of 7 subtests. We used a scoring system (each subtest score ranged from 0 to 15, and the total score ranged from 0 to 105). |
| grip strength | 4 weeks | measure grip strength, the higher values indicating a more strength |
Countries
South Korea
Outcome results
None listed