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Effectiveness of paraffin and sustained stretch in treatment of shoulder contractures following a burn injury
Holavanahalli RK, Helm PA, Kowalske KJ, Hynan LS
Archives of Physical Medicine and Rehabilitation 2020 Jan;101(1 Suppl):S42-S49
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To examine if range of motion of the shoulder treated with paraffin will be better than when treated with sustained stretch alone DESIGN: Pilot randomized control trial SETTING: Regional Burn Center PARTICIPANTS: Patients (N = 23) who sustained a burn injury, with an shoulder active abduction and/or flexion in the +70 degree to +150 degree, who were >= 14 years of age, receiving follow-up physical therapy after discharge from hospital, and provided a signed consent to participate. INTERVENTIONS: Group A received sustained stretch and paraffin and group B received sustained stretch only. Both groups had 6 sessions of treatment over 2 weeks. MAIN OUTCOME MEASURES: Active range of motion (AROM) and active-assisted range of motion (AAROM) for shoulder flexion (SF-AROM and SF-AAROM)) and shoulder abduction (SA-AROM and SA-AAROM) were measured pre and post each treatment session. RESULTS: For pre-treatment measurements, only the results for SF-AAROM had significant time effects. For post-treatment measurements, SF-AROM and SF-AAROM were found to have significant effects for time. Session 1 was found to be significantly lower than sessions 2, 3, 4, and 6 for both measures and additionally session 1 was significantly lower than session 5 for SF-AAROM. For SA-AROM, a group by time interaction effect was found significant with scores for the paraffin group relatively stable across sessions and the non-paraffin group had peeks at session 3 and 6. There were no significant effects for (i) within session changes to examine improvement during a session; or (ii) pre-session scores across the 6 sessions showing maintenance of motion. Total change from the first session pre-session measurement to the sixth session post-session measurement for the two treatment groups were non-significantly different. CONCLUSIONS: As shown in this study sustained stretching with paraffin may be a valuable adjunct to range of motion intervention for the shoulder after burn injury.

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