The Effect Of Early Rehabilitation Program On Physical Functions In Patients With Lower Extremity Burn Injuries-A Pilot Study
Ozden Ozkal, Semra Topuz, Ali Konan, Kemal Kismet
Objectives: Impairments in joint range of motion, gait ability and balance cause physical disability in patients with lower limb burns. So that, early rehabilitation program (RP) has becoming increasingly important in acute burn care.  The purpose of this study was to examine the effect of early RP on physical functions in patients with lower limb burns.
Methods: Seven adults with lower extremity burns (4F,3M; mean age=33±11 years, mean burn surface area=4.8±3.5%) were included in this study. GAITRite system for gait parameters, timed up and go test (TUG) for dynamic balance and six minute walk test (6MWT) for exercise capacity were used. These evaluations were made twice; initial (admission) and final (discharge). RP was applied by physiotherapist during the acute hospitalization. RP included active range of motion exercises, functional mobility, balance activities and gait training.
Results: The mean sessions of rehabilitation program were 12 days. In the initial and final evaluations were found as step length 42.70±9.01cm vs. 58.29±4.13cm (burned side), 39.64±10.63cm vs. 59.19±3.97cm (nonburned side), cadence 79.11±21.52 vs. 105.11±10.07 steps/min, velocity 56.94±24.67 vs. 102.91±11.74 cm/sec, and distance 6MWT 154.84±47.43 vs. 480.14 ±60.56 m respectively. When the initial and final evaluations were compared  there were significant differences for all these parameters(p˂0.05). Although base support was shorter in final measurements, there was no significant differences between the initial and final values (18.34±8.35 vs. 12.56±3.07 cm, p˃0.05). Initial TUG values were higher than the final values  and the differences were significant (18.30±4.73 vs. 9.51±0.89 sec. p=0.01). 
Discussion/Conclusion: This prospective pilot study showed significant improvements in physical functions during early RP. Gait parameters, exercise capacity and balance are very important indicators of effectiveness of early RP after burn injuries. The limitation of this study was its small sample size. Future studies may compare the effectiveness of different rehabilitation programs in larger burned population.