The Clinical Utility of Extracorporeal Shock Wave Therapy on Hand Burns

The Clinical Utility of Extracorporeal Shock Wave Therapy on Hand Burns : a Randomized Controlled Study

No study has investigated the effect of extracorporeal shock wave therapy (ESWT) on hand function and hypertrophic scar characteristics. To investigate ESWT effects on burned hands, the investigators compare the results of ESWT combined with manual therapy group to the results of matched conventional(CON) rehabilitation combined with manual therapy group.

Hands are the most frequent injury sites caused by burn, and appropriate rehabilitation is essential to ensure that good functional recovery is achieved. In burn patients, the wound healing process may lead to a fibrotic hypertrophic scar, which is raised, red, inflexible and responsible functional and cosmetic impairments.

This randomized, controlled trial involved 40 patients with burns and dominant right-hand function impairment. Patients were randomized into a ESWT or a CON group. Each intervention was applied to the affected hand for 4 weeks once per week. Hand function was evaluated using the Jebsen-Taylor hand function test (JTT), grasp and pinch power test, and Michigan Hand Outcomes Questionnaire (MHQ). These assessments were evaluated pre-intervention and 4 weeks post-intervention.

Inclusion Criteria:

• a deep partial-thickness (second-degree) burn or a full thickness (third-degree) burn to their hands
• less than 6 months since the onset of the burn injury

Exclusion Criteria:

• fourth-degree burns(involving muscles, tendons, and bone injuries)\
• musculoskeletal diseases(fracture, amputation, rheumatoid arthritis, and degenerative joint diseases) in the burned hands
• neurological diseases(such as peripheral nerve disorders)
• preexisting physical and psychologic disability (severe aphasia and cognitive impairment that could influence the intervention)
• severe pain impeding hand rehabilitation