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Patterns and predictors of hand functional recovery following pediatric burn injuries: Prospective cohort study
Mohammed Ta Omar1, Zizi M Ibrahim2, Amr B Salama3
1Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Egypt; Rehabilitation Health Science Department, College of Applied Medical Sciences, King Saudi University, Saudi Arabia.
Insights
Children
Area of Science:
- Pediatric burn recovery
- Hand function rehabilitation
- Functional outcomes in pediatric burns
Background:
- Burn injuries in children can significantly impair hand function.
- Understanding the recovery trajectory and predictors is crucial for effective intervention.
Purpose of the Study:
- To characterize hand functional recovery patterns in pediatric burn survivors during the first six months post-discharge.
- To identify key predictors influencing this recovery process.
Main Methods:
- Prospective, comparative cohort study of 37 children with upper extremity burns (TBSA<35%).
- Hand function assessed using Total Active Motion (TAM), grip strength, and Jebsen Hand Function Test (JHFT) at discharge, 3, and 6 months.
- Comparison with 36 healthy children.
Main Results:
- Significant improvements observed in TAM, grip strength, and JHFT scores over the 6-month follow-up period.
- Predictors of recovery included time to surgery, rehabilitation engagement, hand dominance, age, and TBSA.
- These predictors accounted for a substantial portion of the variance in functional recovery.
Conclusions:
- Hand function significantly improves in children after burns within six months of discharge.
- Identifying predictors allows for tailored rehabilitation strategies to optimize outcomes for pediatric burn patients.
Purpose:
To describe the pattern of hand functional recovery in the first six months following the discharge of children with burn injury, and to identify the predictors affecting this recovery.
Materials And Methods:
This was a prospective, comparative, follow-up cohort study in which hand functional outcome, was assessed during 9 months follow-up on 37 children with burn injuries involving the upper extremity with total body service area (TBSA<35%). Thirty-six matched healthy children were participated to compare the differences between children with burn and healthy children regarding the hand functional outcome. Hand function assessments included total active motion (TAM), grip strength and Jebsen Hand Function Test (JHFT) were conducted at hospital discharge, 3, and 6 months follow-up after discharge.
Results:
We found a trend towards an increase in the TAM scores over time (P<0.001), and were excellent in 5.41%, at discharge and increased to 18.92% and 40.54% at 3 and 6-month following discharge. The hand grip strength and JHFT showed significant improvement over time after 6 months (P<0.001). Regression analysis revealed that time to surgery, engagement in rehabilitation services, hand dominance, age and TBSA were the predictors of hand functional recovery and accounted 74% for TAM, 0.79 and 0.86 for total JHFT scores and grip strength.
Conclusions:
the TAM, grip strength and JHFT were significantly improved after 3-month and these improvements were more evident at 6-month following discharge. Identification of the predictors may help therapists in the development of an effective rehabilitation programs.
