ABSTRACT
Total-contact burn masks are used to treat scar tissue hypertrophy of the face. The mask should conform very closely to the contours of the face and provide evenly distributed pressure. The mask is worn continually throughout wound maturation. Lack of fit because of an inability to obtain exact facial contours by use of an alginate material diminishes the effectiveness of the mask. A multidisciplinary team representing physical therapy, CAD/CAM (computer-aided design and computer-aided manufacturing), biomedical engineering, and prosthetics has advanced the method of developing total-contact burn masks by use of human body electronic imaging, computer graphics, and numerically controlled milling processes. High-resolution surface scanning and CAD/CAM have been used successfully to accurately fabricate three such masks. The methodology and preliminary results from use of these state-of-the-art techniques are described in this article.
Subject(s)
Burns/rehabilitation , Cicatrix, Hypertrophic/rehabilitation , Computer Graphics , Facial Injuries/rehabilitation , Image Processing, Computer-Assisted , Masks , Humans , Patient Care Team , PressureABSTRACT
Chronic hand edema after wound healing is a troublesome condition to treat in patients with burns. Stagnant edema can cause fibrosis, which impedes rehabilitation and may lead to deformity. Although favorable results have been reported with mechanical compression used in acute injuries, no literature was found on the effects of compression for the treatment of chronic hand-burn edema. Five male patients with nine chronically edematous burned hands were subject to mechanical compression at 55 mm Hg pressure. A single-cell unit was used for a 30-minute treatment at 4:1 treatment ratio. Goniometric and volumetric hand measurements were recorded both before and after treatment. Although patients expressed a subjective feeling of improvement, no statistical difference was found in finger joint range of motion nor in hand volume when comparing pretreatment and posttreatment measurements. Many different treatment protocols exist in the literature and are discussed.
Subject(s)
Burns/therapy , Edema/prevention & control , Gravity Suits , Hand Injuries/therapy , Hand , Adult , Burns/complications , Equipment Design , Finger Joint/physiology , Hand Injuries/complications , Humans , Male , Metacarpophalangeal Joint/physiology , Range of Motion, Articular/physiologyABSTRACT
This study was designed to evaluate the Scoliometer, an instrument that measures axial trunk rotation in individuals with scoliosis. The objectives included determining 1) the Scoliometer's screening capability and validity and 2) the intrarater and interrater reliability of Scoliometer measurements. Scoliometer measurements made by two raters on 65 persons with idiopathic scoliosis were correlated with radiographic assessment of vertebral (pedicle) rotation and lateral curvature (Cobb method). Correlation ranged from .32 to .46 with pedicle rotation and from .46 to .54 with the Cobb angle. Frequency analysis revealed relatively good specificity, sensitivity, and predictive capability of the Scoliometer. Intrarater and interrater reliability coefficients were high (r = .86-.97). These results indicate good measurement reproducibility. The less-than-optimal between-method correlation coefficients suggest that the validity of Scoliometer measurements is not sufficient to use this method alone for determining patient diagnosis and management. Based on the positive-frequency analysis, however, the use of this tool as a screening device would be appropriate.
