The use of a splint, serial casting and passive stretching have been described in the
literature as conservative interventions to manage joint contractures after burn injury.
There is a paucity of literature investigating the effect of serial casting on scar
contractures following upper extremity (UE) burn injury in adults and a lack of studies
using strong methodological approaches. There are also no studies investigating the
effect of casting on hypertrophic scars (HSc) and on self-reported UE function. This
study is a longitudinal case series design with a criteria for change on the use of
serial casting for the treatment of upper extremity burn contractures. The purpose of
this study is to estimate the extent to which range of motion (AROM and PROM), scar
characteristics and patient-reported upper-extremity function changes following an
individually-tailored serial casting treatment program after switching from one week of
usual care and to determine if these changes can be maintained 3 weeks after stopping
serial casting, for adult burn survivors who developed an upper-extremity joint
contracture greater than 15% normal range of motion within 1-year post-burn. This study
will be a longitudinal case series design with a criteria for change. A minimum of 12
participants will be recruited from the "Centre d'expertise pour les victimes de brûlures
graves de l'ouest du Québec" (CEVBGOQ) and will undergo one week of "usual care". If the
PROM of the joint does not improve after one week of usual care, the participant will
start the serial casting process, which will be prescribed by the treating OT. PROM/AROM
and scar characteristics will be measured using a revised goniometry protocol that
incorporates cutaneokinematics (CKM) principles and precise skin measures (DermaScan C,
Cutometer®, Mexameter® and Tewameter®) at baseline, every Monday and Friday of the
treatment weeks and 3 weeks after treatment cessation. Self-reported UE function and
satisfaction related to scarring will be assessed at baseline and 3 weeks after treatment
cessation using the QuickDASH and the patient satisfaction assessment scale (PSAS).
Analysis on ROM and scar characteristic will be conducted using a graphical
representation with a projected "usual care" regression line to count how many outcomes
were over the line once the treatment was introduced. This study will contribute to
building evidence for the use of serial casting following UE burn contractures in the
adult population.