Refining the idiom "functional range of motion" related to burn recovery.

The term "functional" in burn rehabilitation has gained widespread use to describe a patient's recovery after burn injury. But what truly is "functional" when applied to a patient recovering from burn injury? A literature search was performed for information defining "functional" range of motion (ROM). Maximum upper and lower ROM values to perform a variety of daily activities were abstracted and compared with published outcomes of patient groups recovered from burn injury. Seventy references were reviewed leading to categorizing 11 activities and 26 joint motions. Seven burn outcome articles were found that classified patient scar contracture severity based on ROM. In comparing the results, many burn survivors with severe burn scar contractures could be considered "functional." Refinement of the term "functional" is needed related to burn outcomes. Functional ROM of a particular joint to perform one specific task may be insufficient to perform a variety of other tasks when all planes of motion are considered. Use of the term "functional" to describe a patient's outcome should be used in a guarded manner.

Combat operational stress control in Iraq and Afghanistan: Army occupational therapy.

One of the primary roles for U.S. Army Occupational Therapists (OTs) during combat operations is the Behavioral Health (BH) mission. Army OTs have been involved in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) providing BH treatment to service members, serving in Brigade Combat Teams, and Combat Stress Control Units, however, the impact of the OT BH mission has been scarcely documented. Although the theoretical deployment role of OTs in Combat and Operational Stress Control (COSC) operations has been described, the literature provides minimal experiential application of OTs in the COSC role. This article describes the deployed operational roles of three OTs, two deployed during OIF and one in OEF during 2008-2010. Deployed assignments included positions as Officers in Charge of restoration centers, and of prevention centers to include animal-assisted therapy, and disaster response. Occupational therapists play a vital role within the COSC unit as they add the unique perspective of assessing the service member's functional performance in daily living occupations.