Multi-axis shoulder abduction splint in acute burn rehabilitation: a randomized controlled pilot trial

Abstract

Objective: The traditional thermoplastic aeroplane splint for axillary burn contracture is heavy, uncomfortable, and time consuming and difficult to put on and off. The present study tested the effectiveness of a newly designed multi-axis shoulder abduction splint with an easy-to-change angle. Design: Randomized controlled parallel assessor blinded pilot. Setting: Inpatient rehabilitation center in a general hospital. Subjects: Twenty-four patients with recent (< 30 days) burns around the shoulder joint were randomized into two groups. After two dropouts, 11 patients used the new splint for four weeks and 13 patient were left unsplinted for four weeks. Interventions: The newly designed multi-axis shoulder abduction splint keeps the shoulder abducted at the highest possible angle. Main outcomes: The range of motion of the shoulder joint was measured at 0, 1, 2, 3, and 4 weeks. Active abduction, flexion, and external rotation were measured according to the zero position method by placing the axis of the goniometer ventral to the shoulder joint. Results: Repeated-measure ANOVA revealed that the splint group developed significantly better abduction (P = 0.020) and flexion (P = 0.036) over 4 weeks than the non-splint group. ANCOVA using the initial (0 week) angle and Shoulder Burn Depth Index as covariates revealed that the splint group had significantly better abduction than the non-splint group (P = 0.013). Conclusion: The new multi-axis shoulder abduction splint resulted in a significant improvement in shoulder abduction angle compared to unsplinted patients.