Abstract
A 28-year-old male patient with 85% total body surface area full-thickness burns to the neck, bilateral upper extremities, anterior and posterior trunk, bilateral buttocks, and genitalia was seen 5-6 days per week by a student physical therapist over a 12-week period at a burn intensive care unit at a regional burn center. Treatment was provided under the supervision of a licensed physical therapist.
The patient was evaluated at the initial encounter using goniometry, the Numeric Pain Rating Scale, the Physical Function in Intensive Care test, the Activity Measure for Post-Acute Care, and levels of assistance. A plan of care was established to address pain, limited range of motion, impaired functional strength and mobility, impaired sitting and standing tolerance, restricted ambulatory status, and the patient’s inability to discharge home. Main goals for the patient were to increase ankle dorsiflexion range of motion, reduce pain, increase independence during functional mobility tasks, and return to ambulation. Main interventions used were stretching, splinting, positioning, task-specific functional mobility, aerobic training, and strength training.
The patient responded well to physical therapy interventions, and showed improvements in ankle dorsiflexion range of motion, functional strength, functional mobility independence, and sitting and standing tolerance. The patient remained hospitalized due to further surgical needs with a plan to be discharged to an inpatient rehabilitation facility when he completed all of his surgeries, was medically stable, and would be able to tolerate intensive therapy before discharging home.