The effects of splinting on shoulder function in adult burns

Introduction: Exercises are commonly prescribed to improve shoulder range following axillary burns, but the effect of additional splinting is unclear. Aim: To compare splinting and exercise to exercise alone in adults with axillary burns. Method: Prospective randomised study allocating participants to a splinting (n = 27) or no splinting group (n = 25). Outcomes measured at six and twelve weeks were shoulder abduction and flexion range, quality of life using the Burn Specific Health Scale-Brief (BSHS-B) questionnaire and upper limb function using the Upper Extremity Functional Index (UEFI) and the Grocery Shelving Task (GST). Results: At week twelve, there was no difference between groups for shoulder abduction (mean difference 0 degrees, 95% CI -22 to 22 degrees), flexion (mean difference 2 degrees, 95% CI -18 to 23 degrees), BSHS-B (mean difference -2 points, 95% CI -23 to 18 points), UEFI (mean difference -3 points, 95% CI -19 to 14 points) and GST (mean difference -9 s, 95% CI -20 to 3 s). Adherence to splinting decreased from 77% of participants at week one to 16% at week twelve. Conclusion: Shoulder splints did not improve clinical outcomes in this study population and low adherence rates suggest splinting may be unacceptable to patients and makes drawing firm conclusions difficult. (c) 2012 Published by Elsevier Ltd and ISBI.