The Clinical Utility of Extracorporeal Shock Wave Therapy on Hand Burns

Hangang Sacred Heart Hospital48 enrolled

Overview

No study has investigated the effect of extracorporeal shock wave therapy (ESWT) on hand function and hypertrophic scar characteristics. To investigate ESWT effects on burned hands, the investigators compare the results of ESWT combined with manual therapy group to the results of matched conventional(CON) rehabilitation combined with manual therapy group.

Hands are the most frequent injury sites caused by burn, and appropriate rehabilitation is essential to ensure that good functional recovery is achieved. In burn patients, the wound healing process may lead to a fibrotic hypertrophic scar, which is raised, red, inflexible and responsible functional and cosmetic impairments. This randomized, controlled trial involved 40 patients with burns and dominant right-hand function impairment. Patients were randomized into a ESWT or a CON group. Each intervention was applied to the affected hand for 4 weeks once per week. Hand function was evaluated using the Jebsen-Taylor hand function test (JTT), grasp and pinch power test, and Michigan Hand Outcomes Questionnaire (MHQ). These assessments were evaluated pre-intervention and 4 weeks post-intervention.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Hand Burn

Interventions

Extracorporeal shock wave therapyOTHER

ESWT was conducted using the Duolith SD-1® device (StorzMedical, Tägerwilen,Switzerland) with an electromagnetic cylindrical coil source for the focused shock wave. ESWT was performed around the primary treatment site at 100 impulses/cm2, an energy flux density(EFD) of 0.05 to 0.30 mJ/mm2, frequency of 4Hz, and 1000 to 2000 impulses were administered at 1-week intervals for 4 sessions.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * a deep partial-thickness (second-degree) burn or a full thickness (third-degree) burn to their hands * less than 6 months since the onset of the burn injury Exclusion Criteria: * fourth-degree burns(involving muscles, tendons, and bone injuries)\\ * musculoskeletal diseases(fracture, amputation, rheumatoid arthritis, and degenerative joint diseases) in the burned hands * neurological diseases(such as peripheral nerve disorders) * preexisting physical and psychologic disability (severe aphasia and cognitive impairment that could influence the intervention) * severe pain impeding hand rehabilitation

Locations (1)

Hangang Sacred Heart Hospital

Seoul, Yeong-deungpo-Dong, South Korea

Outcomes

Primary Outcomes

thickness

scar thickness(cm)

Time frame: 4 weeks

melanin and erythema

measure melanin levels and the severity of erythema. The higher values indicating a darker and redder skin(AU)

Time frame: 4 weeks

transepithelial water loss

the degree of water evaporation

Time frame: 4 weeks

sebum

the severity of greese, the higher values indicating a more greese(mg/cm2)

Time frame: 4 weeks

elasticity

The numeric values (mm) of the skin's distortion is presented as the elasticity.

Time frame: 4 weeks

Secondary Outcomes

grip strength

measure grip strength, the higher values indicating a more strength

Time frame: 4 weeks

Jebsen-Taylor hand function test

The JTT measure the performance speed of standardized tasks. The JTT involves a series of 7 subtests. We used a scoring system (each subtest score ranged from 0 to 15, and the total score ranged from 0 to 105).

Time frame: 4 weeks

Data from ClinicalTrials.gov

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