Serial Casting for Upper Extremity Burn Contractures

Last updated: February 17, 2025
Sponsor: Centre hospitalier de l'Université de Montréal (CHUM)
Overall Status: Active - Recruiting

Phase

N/A

Condition

Hyponatremia

Skin Wounds

Treatment

Tailored serial casting intercention

Clinical Study ID

NCT05425433
22.084
  • Ages 16-100
  • All Genders

Study Summary

The use of a splint, serial casting and passive stretching have been described in the literature as conservative interventions to manage joint contractures after burn injury. There is a paucity of literature investigating the effect of serial casting on scar contractures following upper extremity (UE) burn injury in adults and a lack of studies using strong methodological approaches. There are also no studies investigating the effect of casting on hypertrophic scars (HSc) and on self-reported UE function. This study is a longitudinal case series design with a criteria for change on the use of serial casting for the treatment of upper extremity burn contractures. The purpose of this study is to estimate the extent to which range of motion (AROM and PROM), scar characteristics and patient-reported upper-extremity function changes following an individually-tailored serial casting treatment program after switching from one week of usual care and to determine if these changes can be maintained 3 weeks after stopping serial casting, for adult burn survivors who developed an upper-extremity joint contracture greater than 15% normal range of motion within 1-year post-burn. This study will be a longitudinal case series design with a criteria for change. A minimum of 12 participants will be recruited from the "Centre d'expertise pour les victimes de brûlures graves de l'ouest du Québec" (CEVBGOQ) and will undergo one week of "usual care". If the PROM of the joint does not improve after one week of usual care, the participant will start the serial casting process, which will be prescribed by the treating OT. PROM/AROM and scar characteristics will be measured using a revised goniometry protocol that incorporates cutaneokinematics (CKM) principles and precise skin measures (DermaScan C, Cutometer®, Mexameter® and Tewameter®) at baseline, every Monday and Friday of the treatment weeks and 3 weeks after treatment cessation. Self-reported UE function and satisfaction related to scarring will be assessed at baseline and 3 weeks after treatment cessation using the QuickDASH and the patient satisfaction assessment scale (PSAS). Analysis on ROM and scar characteristic will be conducted using a graphical representation with a projected "usual care" regression line to count how many outcomes were over the line once the treatment was introduced. This study will contribute to building evidence for the use of serial casting following UE burn contractures in the adult population.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Burn survivors with >15% loss of PROM of their PIP, MCP, wrist, or elbow in either:flexion, extension, ulnar deviation or radial deviation.

  • Fire, flame or scald burn injury

-≥16 years old

  • have provided informed consent.

Exclusion

Exclusion Criteria:

  • Frostbite, chemical or electrical burn injury

  • A premorbid musculoskeletal or neurological disorder that limited their ROM

  • Have sustained a neurological injury secondary to the burn injury

  • A psychiatric or cognitive disorder that limits their ability to follow the researchprotocol

  • Have been diagnosed with heterotopic ossification

  • PROM is contraindicated for any reason

  • Do not understand English or French.

Study Design

Total Participants: 12
Treatment Group(s): 1
Primary Treatment: Tailored serial casting intercention
Phase:
Study Start date:
September 20, 2022
Estimated Completion Date:
September 20, 2025

Study Description

Participants will undergo a tailored intervention based on their needs.

Connect with a study center

  • Hôpital de réadaptation Villa Médica

    Montreal, Quebec H2X 1C9
    Canada

    Active - Recruiting

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