SCAR CONTRACTU RES AFTER BURN INJURY : A FUNCTIONAL APPROACH?

Oosterwijk, A.M. (Anouk) (2013) SCAR CONTRACTU RES AFTER BURN INJURY : A FUNCTIONAL APPROACH? thesis, Human Movement Sciences.

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Abstract

Scar contracture is a common complication after deep dermal and full thickness burns, especially in the upper extremity and is defined as a loss of maximal range of motion (ROM) in a movement direction of a specific joint. A variety of classifications exist to rate the severity of these contractu res, but none is explicitly based on functional outcome. This study aims to clarify the concerns of the classifications and give a substantial impetus to a functional approach. To end this, a literature search is conducted on the classification systems and ROM data is used to clarify the concerns. Five concerns are analysed: 1) The limit between none and mild contracture is not explicit indicated, and 2% motion restriction is already labelled as a mild contracture. 2) Confusion arises about what degree of ROM is related to 100% ROM as different references are available. 3) Boundaries of the severity levels are not similar per classifications, mainly when contracture severity increase; therefore a moderate scar contracture in one classification may be considered severe in another. 4) No discrimination is made between for example 75% and 99% of normal ROM, while that is functionally necessary. 5) The severity levels of the classifications are similar for all joint angles, while the functional outcome differs per joint angle. Therefore, we are convinced that a functional approach is required. In this approach, severity levels have to be investigated per joint and per movement direction separately based on participation in daily activities.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor: and Mouton, Leonora J. PhD and Centre for Human Movement Sciences, University of Groningen and Centre Groningen, Groningen
Supervisor name:	Nieuwenhuis, Marianne K. PhD and Association of Dutch Burn Centres, Burn Centre Martini Hospi and Netherlands
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:05
Last Modified:	25 Jun 2020 11:05
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2493

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