Exercise and Splinting

Why Exercise and Splinting?

People who sustain burn injuries can experience reduced activity performance due to periods of immobilisation, ventilator dependence, the burn-related catabolic response, pain, limiting scars, muscle weakness and reduced fitness levels. High levels of fatigue may also be experienced. Many of these problems can be more noticeable after discharge from hospital.

Recommendations

It is recommended that individuals over 7 years of age should be evaluated for strength and cardiovascular performance. Any limitations can benefit from a structured, supervised resistance and/or aerobic program.

Research has shown that patients who had a structured exercise resistance program versus those who did not, required fewer invasive surgical procedures to improve range of movement (ROM). They also had greater aerobic capacity, muscle strength, and lean body mass, and returned to work sooner.

Exercise can help reduce contractures. Evidence suggests that exercise can be as effective as splinting in improving and keeping range of motion.

Splinting however, can be an important component of managing a scar. Splints are rigid and often made of thermoplastic material which is formed to the body. Splints are usually made especially for you by a therapist, or sometimes they are ready-made. Splints can be used to protect an area after a surgery. For scars near or over a joint you could need a splint if there is concern that you may lose movement. Splints can also be effective by providing a long and sustained stretch to scars that are already limiting movement at a joint. Splints are ofeten removed intermittently so that the splinted area can also be moved and exercised.

Exercise programs start in hospital; it’s very important to continue and progress your exercise program regularly after discharge from hospital. It is important to have continued input from a scar specialist physiotherapist who understands the impact of scar on your recovery and how your scar is likely to change over time. It can be important to continue the exercise program throughout the scar maturation process (up to 2 years).

Exercise therapy is advised for all patients with scar. The intensity and duration of exercise will depend on the scar and the time since injury.

Adverse effects

There are no reported direct adverse effects linked to controlled exercise programs.

Photo of legs of a person doing exercise with exercise band and weights

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F.A.Q.

How can movement and splinting help reduce scars?

Movement and splinting can both help reduce scars by promoting healthy healing and preventing abnormal scar formation. Movement helps maintain the flexibility and mobility of the tissue around the scar, making the scar less rigid and increasing the range of motion. Regular movement also helps prevent adhesions that can form between scar tissue and underlying structures. Splinting can be used to apply constant stretch to the scar, allowing scar tissue to develop in a more favorable direction and reducing the risk of contractures.

How often and how long should I wear the splint to be effective?

The frequency and duration of wearing a splint vary depending on individual needs and the healthcare provider’s instructions. Generally, it is recommended to wear the splint daily as prescribed by the therapist, and to remove it as needed for exercises and cleaning. This may involve wearing the splint during certain periods of the day or night, depending on the treatment goals and the scar’s response to the therapy.

Are there risks associated with using splints or performing movement exercises on scars, such as worsening the scar tissue?

Risks associated with using splints and performing movement exercises on scars include worsening of the scar tissue, pain and discomfort, and the risk of contractures. These risks are usually the result of improper use. They can be minimized by closely following the healthcare provider's instructions, maintaining regular communication about any issues, and gradually building up the exercise program under the guidance of a physical therapist.