Range of Motion - Physiotherapy/Occupational Therapy

Range of Motion - Physiotherapy/occupational Therapy

Range of Motion (ROM) Most patients, regardless of severity or extent of burn, will initially be able to achieve full active range of all joints. ROM RESTRICTION Two restrictions apply to early joint range:

No full fisting (flexion of all finger joints at once) if burns appear to be deep 2nd or 3rd degree as there is a possibility of extensor tendon rupture. The Joints can safely be moved in combinations of MCP flexion with PIP and DIP extension or MCP extension and DIP flexion.
No full hand and wrist extension if burns to volar wrist appear to be deep 2nd or 3rd degree as there is a possibilty of carpal tunnel damage.

As edema increases (over 12-72 hours) range will decrease. Therefore, it is imperative to ensure elevation of the involved area (including the head if involved) to assist edema reduction. Range will also decrease as pain intensifies therefore adequate pain control is required.
Monitored ROM exercises, including active and active assisted, in the early phase decrease muscle spasm and improve circulatory exchange that assists the healing process and aids in preventing complications if the patient is on bedrest. Escharotomies do not indicate any need for limitation of ROM, while blisters indicate the need for cautious ROM to keep them intact (once broken, however, ROM can be full). ROM of facial muscles must also be encouraged in order to maintain functional mouth and eye movement.
No ROM is done for 5 days following grafting, after which a graduated return to a full exercise program can be resumed. Refer to Rehabilitation Phase Physiotherapy Support for continuing care.
If ROM has been maintained and the injury heals on its own within two weeks there is little, if any, effect of the burn remaining. If ROM has not been encouraged joint stiffness will be experienced.

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