A Systematic Review on the Effect of Mechanical Stretch on Hypertrophic Scars after Burn Injuries.
Yu-Ting Zhang, Cecilia W P Li-Tsang, Ricky K C Au
PMID 30186067WHAT IT FOUND
Burn scar stretch, massage and splint trials were mixed, and each was combined with other burn care.
Do not treat any single component as proven.
Key findings
01Across included trials, two of six studies reported significantly improved scar properties, and three of four studies reported improved range of motion at scar-adjacent joints.
02Early burn rehabilitation with stretching exercise, active exercise and daily activities reported a significant decrease in number of contractures compared with conventional treatment.
03Adding a shoulder splint to conventional stretching, strengthening and functional training did not improve shoulder range of motion after 6 weeks all-day and 6 weeks night wear.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only nine included trials had full text. The review could not define a reliable stretch, massage or splint protocol. PEDro scores were five high, two fair and two poor. Assessor blinding was often absent. Treatment regimes and outcome measures varied. Direct comparison was difficult. All stretch-incorporated treatments were applied with other treatments, such as active exercise, pressure garment, moisturisation or functional retraining. Single-component effects cannot be separated.
The easy way to misread this
Do not conclude that stretching, massage or splinting alone improves burn scars. The trials added these treatments to other burn care, used different protocols and outcome measures, and several results were null.