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Measuring What Matters: Validating the HANDFULS Tool with Pediatric Burn Survivors
Ingrid Parry1, Sandra Taylor2, David Greenhalgh1
1Shriners Childrens' Northern California, 2425 Stockton Blvd. Sacramento, CA 95817, United States.
Summary
A new study validated the Hand Accumulation and Dexterity Functional Limits-Shriners (HANDFULS) measure for pediatric hand burn survivors. The HANDFULS tool shows significant improvement in hand function and dexterity over two years post-burn.
Area of Science:
- Pediatric burn rehabilitation
- Hand function assessment
- Outcome measurement validation
Background:
- Hand and finger burns are common in children, leading to significant functional limitations.
- Validated outcome measures for pediatric burn survivors' hand function are scarce.
- In-hand manipulation (IHM) and palmar workspace volume (PWV) are frequently impaired after burn injuries.
Purpose of the Study:
- To validate the Hand Accumulation and Dexterity Functional Limits-Shriners (HANDFULS) measure in pediatric patients with hand burns.
- To establish functional recovery trajectories for pediatric hand burn survivors compared to age-matched non-injured peers.
- To assess the impact of surgical status on hand function recovery.
Main Methods:
- A prospective longitudinal study followed 119 children (165 hands) for two years post-burn.
- Hand function was assessed using the HANDFULS measure, evaluating IHM and PWV.
- Mixed-effects models were used to analyze changes in hand function over time, controlling for confounders and comparing results to non-injured peers.
Main Results:
- Both PWV and HANDFULS scores showed significant improvement over two years, with the most substantial gains occurring between 2-6 months post-burn.
- Surgical patients exhibited lower PWV at early time points but demonstrated comparable HANDFULS scores, indicating preserved dexterity.
- By 24 months, a significant percentage of children with hand burns achieved normal limits in PWV (77.6%) and HANDFULS scores (78.1%), approaching those of non-injured peers.
Conclusions:
- The HANDFULS measure is a valid, reliable, and feasible tool for assessing hand function recovery in pediatric burn survivors.
- HANDFULS provides objective data crucial for clinical decision-making and guiding rehabilitation strategies for pediatric hand burn patients.
- The study establishes functional recovery trajectories, highlighting the potential for significant functional improvement over time with appropriate interventions.
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