Ms Cheri Templeton1, Ms Claire Toose1, Ms Sarah Baxter1, Prof Andrew Holland1, Dr Erik La Hei1, Dr John Harvey1
1The Children’s Hospital At Westmead, Westmead, Australia
Abstract:
Hand burns are a common injury in children with subsequent hypertrophic scarring posing a particular challenge given its contractile nature and the many joints of the hand. Contracture prevention is crucial, and in our unit intensive splinting at end of range, (≥12 hours/day) for at least 4 months post injury is standard practice. However this intensive rehabilitation may have the potential to adversely affect the natural development of hand function that occurs in children age 0-5 years, which potentially has significant physical, psychological and socioeconomic implications.
This study hypothesized that our current rehabilitation practice, involving intensive end of range splinting, allowed development of fine motor skills of the burned hand to fall within normal age equivalent range as assessed by the Peabody Developmental Motor Scale-2 (PDMS-2) at 12 months post burn injury. This cross-sectional study collected data on 44 children (16 female, 28 male) with a mean age of 34 months (SD 15 months). Data was collected via parent questionnaire, fine motor subset of PDMS-2, and standard goniometry.
Results indicate that intensive splinting following hand burn injury in children does not adversely impact their fine motor development, with 88.4% of participants scoring “average or above average” in the PDMS-2, in keeping with age based norms for the general population. Mean Visual Motor Integration percentile score was 56.5 (SD 24.5) and mean Fine Motor percentile score was 47.5 (SD 21.2). Of 44 study participants, only 1 had presence of loss of ROM, demonstrating that intensive splinting may successfully maintain full ROM.
Biography:
Cheri has over 40 years experience as a burns physiotherapist, working in the paediatric setting. She has an extensive career as a clinician and is a strong advocate for quality paediatric burn care.