Impact of Supervised Active Rehabilitation Program on Functional Activity in Patients with Post Burn Lower Limb

Nancy Hassan Aboelnour, Mahmoud Ewidea, Rafik Radwan

Nancy Hassan Aboelnour, Mahmoud Ewidea, Rafik Radwan – Impact of Supervised Active Rehabilitation Program on Functional Activity in Patients with Post Burn Lower Limb. Fizjoterapia Polska 2020; 20(2); 102-108

Abstract
Objective. To determine whether active rehabilitation program including both isokinetic and aerobic exercises in lower limb after burn is effective or not? Method. Forty patients with lower limb burn were randomly divided into two equal groups, Group A (active rehabilitation group): received guidelines protocol (range of motion exercise, massage, splinting, stretching) plus active rehabilitation program consisted of combined isokinetic and aerobic exercises, while Group B (control group): received guidelines protocol and aerobic exercises. Treatment program was applied for 12 weeks (3 sessions/week). Evaluation methods included Biodex isokinetic dynamometer (BID) for obtaining peak torque (PT) of quadriceps and hamstring strength assessment and Lower Extremity Functional scale (LEFS) for functional activity assessment of lower limb. All measures were gathered before the start of the study, and after termination of the trial (after 12 weeks).
Results. An increase in PT of quadriceps and hamstring was reported in both groups at the end of the trial, 32.69% and 25.7% respectively in group A, while 14.19% and 10.22% respectively in group B. The difference between both groups was statistically significant (p < 0.05). Also, there was a statistical improvement in LEFS score in group A compared with that of group B (p < 0.05), as the percent of improvement in group A and B was 72.9% and 38.91% respectively. Conclusion. Higher statistical results were achieved with active rehabilitation program illustrating the prominent effects of isokinetic exercises in lower limb burn in the term of improving leg muscles strength and functional activity.

Key words:
Burn, Isokinetic exercise, Aerobic exercise, Biodex isokinetic dynamometer (BID), and Lower Extremity Functional scale (LEFS)

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Focused versus radial extracorporeal shock wave therapy in post burn hypertrophic scar: A single blinded randomized controlled trial

Nancy Hassan Aboelnour, Najlaa Fathi Ewais, Hamada Ahmed Hamada

Nancy Hassan Aboelnour, Najlaa Fathi Ewais, Hamada Ahmed Hamada – Focused versus radial extracorporeal shock wave therapy in post burn hypertrophic scar: A single blinded randomized controlled trial. Fizjoterapia Polska 2019; 19(4); 150-155

DOI: https://doi.org/10.56984/8ZG1A3652

Abstract
Purpose. Hypertrophic scar (HTS) is one of the common post-burn complications that lead to functional and cosmetic impairments, so we pursued to examine efficacy of extracorporeal shock wave therapy (ESWT) on HTS in expression of improving scar thickness and appearance. Materials and Methods. 60 patients with post burn HTS were recruited in this trial and divided randomly into 3 equal groups. Group A: received focus ESWT (100 shock waves per cm2, 0.037 mJ/mm2, 4 Hz, 2 times/week for six weeks) plus traditional topical medication (MEBO Scaro cream). Group B: received radial ESWT (500 shock waves per cm2, 0.13 mJ/mm2, 6 Hz, 2 times/week for six weeks) plus MEBO Scaro cream. Group: received only MEBO Scaro cream. Ultrasonography was utilized for scar thickness measurement and scar characteristics assessment was done by Modified Vancouver Scar Scale (MVSS). All measures were gathered before the start of the study, and after termination of the trial (after 6 weeks). Results. Both focus and radial ESWT showed significant advance in scar thickness and MVSS post treatment (p > 0.001), without statistical differences between them (p > 0.05), while group C showed only a significant diminution in MVSS post treatment (p > 0.001), without any change in scar thickness. Conclusion. Higher statistical results were achieved with both focus and radial ESWT without any side effects, confirming the safety and efficiency of ESWT in HTS management.

Key words:
hypertrophic scar, Extracorporeal Shock Wave Therapy (ESWT), Modified Vancouver Scar Scale (MVSS), ultrasonography

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