National Burns Centre ::: A 50 beded Burns Hospital at Airoli, New Mumbai :::

Physiotherapy management in Burns:

Rehabilitation of a Burns patient begins with the moment He or she arrives at our centre & is an changing process that may need to be modified daily. The physical rehabilitation consist of prevention of scar contracture, restoration of normal range of motion( ROM),prevention and minimization of hypertrophic scar and improvement in muscular strength and cardiovascular endurance and to help the burns victim to return to function and performances of activities of daily living.

Physical therapist interacts with other members of burn team to assist patient in obtaining this outcomes. Patients can expect to return to a normal and productive life provided he/she complies with treatment plan. For most patients the most difficult phase of rehabilitation occurs after the wound have healed and that scar tissue begins to contract. If a physical therapist is actively involved in the burns treatment team and can establish a programme of movement rehabilitation in conjunction with the wound healing process. Rehabilitation after healing will be much easier and more successful.

Physiotherapy interventions:

Patients with burn usually begin Physical therapy on the day of admission following assessment and evaluation. The initial assessment of a patient will determine which area needs to be addressed first. Control and resolution of edema and preserving ROM usually are the first priority of physical therapy and treatments. Elevating the extremities and encouraging active movements especially of the hands and an ankles help to minimize the edema formation. Prevention of scar contraction can be accomplished through positioning, splinting and exercise. Exercise and ambulation also will help to minimize detritus effects of bed rest following wound closure. Massage and compression therapy will assist with minimizing contracture formation and management of burn scars. Positioning, splinting and exercise are three relatively simple procedures effective in healing the scar contracture process. Active assisted and passive exercise should be initiated if a patient cannot fully achieved active ROM.

We have the following instruments which are required for full range of physiotherapy exercises:

	Shoulder wheel & shoulder ladder: To improve shoulder ROM.
	Inclined sanding & Slings: To improve shoulders and Elbow ROM.
	Horizontal Sanding: To improve Elbow &wrist ROM
	Elbow board: To improve elbow ROM.
	Pronator & Supinator: To improve wrist ranges and muscle power.
	Peg Board: To improve grasp, opposition &pinch
	Resistive finger Exerciser: For hand muscle strengthening.
	Velcro board: To improve opposition & pinch with graded resistance.
	Exercise ball Soft/Hard: To improve grip and grasp.
	Gripper: To improve grip strength.
	Ankle Exerciser: to improve ankle ROM & muscle power.
	Cycle: To improve HIP, knee & ankle ROM.
	Splint: To keep a particular joint in static position
	Weight Cuffs: To increase the strength of the extremities