Multimodal physiotherapy rehabilitation for chronic burn injury with hypertrophic scarring: a case report

Abstrak

Background: Chronic burn injury may cause hypertrophic scarring, pain, restricted joint movement, and functional limitations.
Objective: To describe changes during four sessions of multimodal physiotherapy rehabilitation in a patient with chronic burn injury and hypertrophic scarring.
Methods: This descriptive single case report involved a 64 year old man six months after burn injury. Outcomes included pain using the Numeric Rating Scale, active range of motion using a goniometer, muscle strength using Manual Muscle Testing, functional independence using the Barthel Index, and scar characteristics using the Vancouver Scar Scale. Program comprised ultrasound, scar massage, active range of motion exercise, wrist stretching, strengthening, and proprioceptive neuromuscular facilitation over four weekly sessions. Reporting followed CARE.
Results: Resting pain decreased from 7 to 4, pressure pain from 3 to 1, and movement related pain from 8 to 5. Shoulder abduction increased from 74° to 82°, shoulder adduction from 66° to 70°, elbow flexion from 122° to 137°, wrist extension from 42° to 50°, ulnar deviation from 53° to 58°, wrist flexion from 14° to 18°, and radial deviation from 19° to 22°. Manual Muscle Testing remained 4/5. Vancouver Scar Scale characteristics were unchanged. Barthel Index remained 100.
Conclusion: After four sessions, the patient showed reduced pain and increased active range of motion, while muscle strength, function, and scar characteristics remained unchanged. These observations describe one patient and cannot establish treatment effectiveness or causality.