Physiotherapy Rehabilitation in Post-Burn Contracture after Skin Graft and Flap: A Case Report

Puput Mardiani; Arin Supriyadi; Made Pradnya Paramita

doi:10.24843/mifi.000001776

Authors

Puput Mardiani Physiotherapy Professional Program, Universitas Muhammadiyah Surakarta, Indonesia Author
Arin Supriyadi Physiotherapy Professional Program, Universitas Muhammadiyah Surakarta, Indonesia Author
Made Pradnya Paramita Physiotherapist at RSUP Prof. Dr. I.G.N.G. Ngoerah Bali, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001776

Keywords:

Burns, Contracture, Skin Transplantation, Physical Therapy Modalities, Range of Motion, Muscle Strength

Abstract

Introduction: Burn injuries can lead to post-burn contractures and functional limitations, particularly in the upper extremities. Although surgical reconstruction using skin grafts and flaps restores tissue integrity, physiotherapy is essential to optimize functional recovery.

Objective: To evaluate the effects of physiotherapy rehabilitation on pain, muscle strength, and range of motion in a pediatric patient with post-burn contracture following skin graft and flap reconstruction.

Methods: This case report involved a 6-year-old child with post-burn contracture of the right upper extremity following split-thickness and full-thickness skin grafts and flap reconstruction. The patient received physiotherapy once weekly for three sessions over two weeks, including infrared therapy, scar massage, and therapeutic exercises. Outcomes were assessed pre- and post-intervention using the Numeric Rating Scale (NRS), Manual Muscle Testing (MMT), goniometer for range of motion (ROM), and Vancouver Scar Scale (VSS).

Results: Pressure pain decreased from NRS 3 to 1 (−66.7%), and movement pain from NRS 2 to 1 (−50%). Muscle strength improved from MMT grade 3 to 4. ROM showed modest improvements, including wrist extension (+2°) and elbow flexion (+5°), while VSS remained unchanged (score 10). No adverse events were reported.

Conclusion: Physiotherapy combining infrared therapy, scar massage, and exercise improved pain, strength, and joint mobility but showed limited short-term effects on scar characteristics. Early and sustained rehabilitation is essential to enhance functional outcomes in pediatric burn patients.