Pilotstudie 07.04

Objectives
Preservation and restoration of range of motion is one of the primary goals in burn care rehabilitation. To this end, patients are treated with intensive splinting and stretching exercises. However, even with this kind of intervention, more than one-third of patients with a major injury develop contracture(s) at hospital discharge. Despite the poor results, static splinting and stretching exercises are still the mainstay in burn care rehabilitation for the prevention of scar contractures. As no other form of treatment to counteract contracture is apparent, drastic improvements need to be made regarding splinting and stretching exercises and their outcome in burns. In this project the focus will be on splinting.

Concerning splinting there is a lack of consensus regarding:       

• timing and duration of intervention,
• choice of splint design,
• body area which has to be treated,
• post clinical approach.

Controversy about splinting strategies exists, because no data are available regarding which patient group is most likely to benefit from splinting or what the specific indications are for splinting.

In line with this, splinting design and application protocols are usually not based on the viscoelastic- and biomechanical properties of scar tissue and in particular on the functional, biomechanical and histological effects of mechanical loading on scar tissue.

Study method
This pilot study will involve a critical review of the literature on splinting and viscoelastic properties of (scar)tissue subjected to mechanical loading, secondly, testing different splint-devices for working principles and suitability and finally, investigating further and deciding on evaluation methods for scar properties, quality and joint mobility.

Anticipated results
This pilot study will provide convincing arguments from literature and clinical use of different splinting strategies to set up and apply for a multicentre randomized controlled trial concerning the effectiveness of splinting in reducing / preventing burn scar contractures.