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Effectiveness of Paraffin and Sustained Stretch in Treatment of Shoulder Contractures Following a Burn Injury

Published:September 25, 2019DOI:https://doi.org/10.1016/j.apmr.2019.08.482

      Abstract

      Objective

      To examine if range of motion of the shoulder treated with paraffin will be better than that of the shoulder treated with sustained stretch alone.

      Design

      Pilot randomized controlled trial.

      Setting

      Regional burn center.

      Participants

      Patients (N=23) who sustained a burn injury, with a shoulder active abduction and/or flexion in the +70° to +150° degree range, who were 14 years or older, were receiving follow-up physical therapy after discharge from hospital, and provided a signed consent to participate.

      Interventions

      Group A received sustained stretch and paraffin, and group B received sustained stretch only. Both groups had 6 sessions of treatment over 2 weeks.

      Main Outcome Measures

      Active range of motion (AROM) and active-assisted range of motion (AAROM) for shoulder flexion (SF) and shoulder abduction (SA) were measured before and after each treatment session.

      Results

      For pretreatment measurements, only the results for SF AAROM had significant time effects. For posttreatment measurements, SF AROM and SF AAROM had significant effects for time. Session 1 was significantly lower than sessions 2, 3, 4, and 6 for both measures, and additionally, session 1 was significantly lower than session 5 for SF AAROM. For SA AROM, a group-by-time interaction effect was significant, with scores for the paraffin group relatively stable across sessions, and the nonparaffin group had peaks at sessions 3 and 6. There were no significant effects for (1) within-session changes to examine improvement during a session or (2) presession scores across the 6 sessions showing maintenance of motion. Total change from the first session presession measurement to the sixth session postsession measurement for the 2 treatment groups were nonsignificantly different.

      Conclusions

      As shown in this study, sustained stretching with paraffin may be a valuable adjunct to range of motion intervention for the shoulder after burn injury.

      Keywords

      List of abbreviations:

      AAROM (active-assisted range of motion), AROM (active range of motion), HEP (home exercise program), ROM (range of motion), SA (shoulder abduction), SF (shoulder flexion)
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