Physiotherapy Management in Older Adults with Partial-Thickness Burn: A Case Report

Abstract

Background: Burn injury in older adults may cause functional decline, contracture, immobilization, and prolonged rehabilitation, particularly in patients with neurological and respiratory comorbidities. Evidence regarding physiotherapy management in frail geriatric patients with burn injury remains limited.
Objective: To describe physiotherapy assessment, intervention, and serial outcomes in an older adult with partial-thickness burn accompanied by recurrent stroke and bilateral pneumonia.
Methods: A descriptive case report was conducted in an 85-year-old female with left-sided partial-thickness burn involving 13.5% total body surface area. Comorbidities included recurrent stroke with right hemiparesis and bilateral pneumonia. Serial evaluations were performed at baseline (T0), week 3 (T1), and week 6 (T2). Outcomes included pain intensity using Numeric Rating Scale (NRS), range of motion (ROM), muscle strength using Manual Muscle Testing (MMT), and functional ability using the Barthel Index. Physiotherapy interventions consisted of positioning, ROM exercise, stretching, strengthening exercise, breathing exercise, and caregiver education.
Results: Initial assessment demonstrated pain intensity of 2/10 at rest and 5/10 during movement, limited elbow flexion (100°), wrist flexion-extension limitation (15°–30°), and Barthel Index score of 20/100. Serial evaluation from T0 to T2 demonstrated gradual wound healing, increased elbow flexion from 100° to 110°, and mild improvement in muscle strength from 2/5 to 3/5 on MMT without contracture formation. Functional dependency remained stable throughout the rehabilitation period.
Conclusion: Physiotherapy rehabilitation in frail older adults with burn injury and multimorbidity should prioritize prevention of functional decline, maintenance of residual function, and minimization of immobilization-related complications through individualized and family-centered approaches.