ORIGINAL PAPER
Hand function response to static progressive splinting in post-burn finger contracture
 
More details
Hide details
1
Faculty of Physical Therapy, Cairo University, Cairo, Egypt
 
2
Faculty of Medicine, Suez Canal University, Ismailia, Egypt
 
 
Submission date: 2021-02-02
 
 
Acceptance date: 2021-04-08
 
 
Publication date: 2022-03-29
 
 
Physiother Quart. 2022;30(1):68-72
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Restoring hand function is an important determinant of the quality of life in victims of burns. The purpose of the study was to determine the changes in the functional outcome when applying a flexion static progressive splint on the metacarpophalangeal joints of the contracted fingers after a burn injury.

Methods:
This study included 60 patients referred to the hand therapy clinic 6 months after the injury. They presented with a burn on the dorsal portion of the hand with limited flexion range of motion in the metacarpophalangeal joints. The participants were randomly assigned to 2 groups (30 patients each). Group A (splint group) were treated with custom-made static progressive flexion splints. Additionally, they received physical therapy and medical treatment throughout the study period (8 weeks). Group B (control group) received physical therapy and medical treatment only. The burned hand was evaluated before and after treatment by measuring the metacarpophalangeal passive range of motion, determining grip strength, and employing the Jebsen-Taylor hand function test to assess the overall hand function.

Results:
A statistically significant increase in all variables occurred in both groups after the intervention, with a higher increase in group A. In groups A and B, the p-values of passive range of motion were 0.001 and 0.784, of grip strength 0.023 and 0.608, and of Jebsen-Taylor hand function test 0.048 and 0.411, respectively.

Conclusions:
Static progressive splint coupled with physical therapy can optimally improve hand function in patients with restricted metacarpophalangeal flexion passive range of motion after burn injuries.

 
REFERENCES (24)
1.
Lotfi M, Mirza Aghazadeh A, Davami B, Khajehgoodari M, Aziz Karkan H, Khalilzad MA. Development of nursing care guideline for burned hands. Nurs Open. 2020;7(4):907–927; doi: 10.1002/nop2.475.
 
2.
Li H-L, Deng Y-T, Zhang Z-R, Fu Q-R, Zheng Y-H, Cao X-M, et al. Evaluation of effectiveness in a novel wound healing ointment – crocodile oil burn ointment. Afr J Tradit Complement Altern Med. 2016;14(1):62–72; doi: 10.21010/ajtcam.v14i1.8.
 
3.
Afifi AM, Mahboub TA, Fouad AI, Azari K, Khalil HH, McCarthy JE. Active range of motion outcomes after reconstruction of burned wrist and hand deformities. Burns. 2016;42(4):783–789; doi: 10.1016/j.burns.2016.02.004.
 
4.
Rrecaj S, Hysenaj H, Martinaj M, Murtezani A, Ibrahimi-Kacuri D, Haxhiu B, et al. Outcome of physical therapy and splinting in hand burns injury. Our last four years’ experience. Mater Sociomed. 2015;27(6):380–382; doi: 10.5455/msm.2015.27.380-382.
 
5.
Fufa DT, Chuang S-S, Yang J-Y. Postburn contractures of the hand. J Hand Surg Am. 2014;39(9):1869–1876; doi: 10.1016/j.jhsa.2014.03.018.
 
6.
Cowan AC, Stegink-Jansen CW. Rehabilitation of hand burn injuries: current updates. Injury. 2013;44(3):391–396; doi: 10.1016/j.injury.2013.01.015.
 
7.
Sabapathy SR, Bajantri B, Bharathi RR. Management of post burn hand deformities. Indian J Plast Surg. 2010;43(Suppl.):S72–S79; doi: 10.4103/0970-0358.70727.
 
8.
Kelly BM, Berenz T, Williams T. Orthoses for the burned hand. In: Webster JB, Murphy DP (eds.), Atlas of orthoses and assistive devices, 5th ed. Philadelphia: Elsevier; 2019; 170–175.
 
9.
Glasgow C, Tooth LR, Fleming J. Mobilizing the stiff hand: combining theory and evidence to improve clinical outcomes. J Hand Ther. 2010;23(4):392–401; doi: 10.1016/j.jht.2010.05.005.
 
10.
Schultz-Johnson K. Static progressive splinting. J Hand Ther. 2002;15(2):163–178; doi: 10.1053/hanthe.2002.v15.015016.
 
11.
Wong K, Trudel G, Laneuville O. Noninflammatory joint contractures arising from immobility: animal models to future treatments. Biomed Res Int. 2015;2015:848290; doi: 10.1155/2015/848290.
 
12.
Akeson WH, Amiel D, Mechanic GL, Woo SL, Harwood FL, Hamer ML. Collagen cross-linking alterations in joint contractures: changes in the reducible cross-links in periarticular connective tissue collagen after nine weeks of immobilization. Connect Tissue Res. 1977;5(1):15–19; doi: 10.3109/03008207709152607.
 
13.
Stewart KM. Therapist’s management of the complex injury. In: Mackin EJ, Callahan AD, Skirven TM, Schneider LH, Osterman AL (eds.), Rehabilitation of the hand and upper extremity, 5th ed. St Louis: Mosby; 2002; 1411–1427.
 
14.
Bhattacharya S. Avoiding unfavorable results in postburn contracture hand. Indian J Plast Surg. 2013;46(2):434–444; doi: 10.4103/0970-0358.118625.
 
15.
Pandya AN. Principles of treatment of burn contractures. Repair Reconstr. 2001;2:12–13.
 
16.
Dewey WS, Richard RL, Parry IS. Positioning, splinting, and contracture management. Phys Med Rehabil Clin N Am. 2011;22(2):229–247; doi: 10.1016/j.pmr.2011.02.001.
 
17.
Glasgow C, Fleming J, Tooth LR, Hockey RL. The long-term relationship between duration of treatment and contracture resolution using dynamic orthotic devices for the stiff proximal interphalangeal joint: a prospective cohort study. J Hand Ther. 2012;25(1):38–47; doi: 10.1016/j.jht.2011.09.006.
 
18.
Glasgow C, Tooth L, Fleming J. Which splint? Dynamic versus static progressive splinting to mobilise stiff joints in the hand. Br J Hand Ther. 2008;13(4):104–110; doi: 10.1177/175899830801300401.
 
19.
Mak MKY, Lau ETL, Tam VWK, Woo CWY, Yuen SKY. Use of Jebsen Taylor Hand Function Test in evaluating the hand dexterity in people with Parkinson’s disease. J Hand Ther. 2015;28(4):389–395; doi: 10.1016/j.jht.2015.05.002.
 
20.
Cummings GS, Tillman LJ. Remodeling of dense connective tissue in normal adult tissues. In: Currier DP, Nelson RM (eds.), Dynamics of human biologic tissues. Philadelphia: FA Davis; 1992; 45–73.
 
21.
MacKay-Lyons M. Low-load, prolonged stretch in treatment of elbow flexion contractures secondary to head trauma: a case report. Phys Ther. 1989;69(4):292–296; doi: 10.1093/ptj/69.4.292.
 
22.
Wang J, Erlandsson G, Rui Y-J, Li-Tsang C. Efficacy of static progressive splinting in the management of metacarpophalangeal joint stiffness: a pilot clinical trial. Hong Kong J Occup Ther. 2014;24(2):45–50; doi: 10.1016/j.hkjot.2014.07.001.
 
23.
Michlovitz SL, Harris BA, Watkins MP. Therapy interventions for improving joint range of motion: a systematic review. J Hand Ther. 2004;17(2):118–131; doi: 10.1197/j.jht.2004.02.002.
 
24.
Culicchia G, Nobilia M, Asturi M, Santilli V, Paoloni M, De Santis R, et al. Cross-cultural adaptation and validation of the Jebsen-Taylor Hand Function Test in an Italian population. Rehabil Res Pract. 2016;2016:8970917; doi: 10.1155/2016/8970917.
 
ISSN:2544-4395
Journals System - logo
Scroll to top