Rehabilitation of the most frequent complications of burn disease

Introduction. Burn injuries often cause severe disfunctions of the motor system and deformities, which - consequently - may lead to a patient’s withdrawal from the social life. The rehabilitation treatment has to cope not only with burn-specific problems (hypertrophied scars, contractures, deformities, disfigurements, muscular atrophy) but also with frequent non-specific problems associated with accompanying injuries (fractures, crushes), consequences of deep burns (amputation, paralysis, paresis) or co-existing diseases. The additional complications of burn disease may hinder the progress of rehabilitation at every stage. Aim of the study. To present the methods of rehabilitation of burn patients with accompanying motor system complications in the course of burn disease as well as to assess their capability to be self-sufficient and to perform everyday activities after hospital rehabilitation has been completed. Material. In 2011, at the Burn Treatment Centre in Siemianowice OEl¹skie, 21 amputations were performed due to burns, in that number 15 amputations within lower limbs and 6 - within upper limbs. Treatment was provided for 10 patients with paresis and/or paralysis in the area of upper and lower limbs and for 12 patients with limb crushes and fractures. In all the cases, the burn injury was accompanied by additional complications of the motor system. Method. The rehabilitation programme included kinesitherapy, physiotherapy, orthopaedic management. It was carried out five days a week in two cycles a day. Simultaneously, rehabilitation treatment recommended for burn therapy was conducted. Results. The patient group under study was assessed according to a modified Barthel score, with an assumption of their having been fully mobile before the injury (patient history). The evaluation was made after the hospital treatment had been completed (on the day of release from hospital). Conclusions. 1. Rehabilitation after a burn injury is a process individually adjusted to the patient’s capability according to his/her general condition and the character of the disfunction. 2. The priority in the treatment of burn patients is given to burn wound healing, therefore rehabilitation may often require modification of the generally accepted principles of physiotherapeutic management. 3. Injuries and additional complications in burn disease are a considerable burden for the patient and an obstacle in the therapeutic process (including rehabilitation). 4. Correctly designed rehabilitation of burn patients significantly reduced their degree of disability.