Zhonghua Shao Shang Za Zhi. 2021 Apr 25;37:1-7. doi: 10.3760/cma.j.cn501120-20200319-00181. Online ahead of print.
ABSTRACT
Objective: To explore the clinical application effects of wedge-shaped heel pad in the treatment of foot drop deformity in extremely severe burn patients. Methods: A retrospective cohort study was conducted. From March 2015 to July 2016, 33 patients with foot drop deformity caused by extremely severe burn who met the selection criteria were admitted to Department of Burn Rehabilitation of Kunshan Rehabilitation Hospital, including 18 males and 15 females, aged (38±9) years. Patients received comprehensive post-burn rehabilitation treatment after admission, and the wedge-shaped heel pad with appropriate height was placed under the patients’ insole, according to the degree of the foot drop deformity in patients. Standing, squatting, and walking exercises were performed after putting on shoes with wedge-shaped heel pad. Before treatment, immediately after treatment, and in 1 month after treatment with wedge-shaped heel pad, the simple balance scale was used to evaluate the standing balance ability of patients. In 1, 3, and 12 months after treatment, active ranges of motion (AROMs) of bilateral ankle joint dorsiflexion and knee joint flexion were measured with joint motion range measuring ruler, the shortest distance between buttocks of patients and the ground when squatting and walking distance in 1 min were measured with metric ruler, and the independent ability of transferring between beds and chairs, walking, and up and down stairs in the movement items of activity of daily living (ADL) in patients were evaluated with modified Barthel index. Data were statistically analyzed with Friedman test, Wilcoxon rank sum test, unequal interval analysis of variance for repeated measurement, and Bonferroni correction. Results: Immediately after treatment, the standing balance ability of patients was 1.0 (0, 1.0) level, which was significantly higher than 2.0 (1.0, 2.0) level before treatment (Z=-5.568, P<0.01); in 1 month after treatment, the standing balance ability of patients was 3.0 (2.5, 3.0) level, which was significantly higher than that immediately after treatment (Z=-5.303, P<0.01). In 3 and 12 months after treatment, the left and right ankle joint dorsiflexion and knee joint flexion AROMs of patients were significantly increased compared with those in 1 month after treatment (Z=-4.860, -4.836, -4.965, -4.909, -5.037, -5.025, -5.020, -4.942, P<0.01); in 12 months after treatment, the left and right ankle joint dorsiflexion and knee joint flexion AROMs of patients were significantly increased compared with those in 3 months after treatment (Z=-5.062, -4.962, -5.017, -4.944, P<0.01). In 3 and 12 months after treatment, the shortest distance between buttocks of patients and the ground was (67±11) and (57±11) cm, which were significantly shorter than (72±11) cm in 1 month after treatment (P<0.01); in 12 months after treatment, the shortest distance between buttocks of patients and the ground was significantly shorter than that in 3 months after treatment (P<0.01). In 3 and 12 months after treatment, the walking distances within 1 min of patients were significantly longer than that in 1 month after treatment (Z=-5.043, -5.016, P<0.01); in 12 months after treatment, the walking distance within 1 min of patients was significantly longer than that in 3 months after treatment (Z=-5.025, P<0.01). In 3 and 12 months after treatment, the independent ability of transferring between beds and chairs, walking, and up and down stairs in the movement items of ADL in patients were significantly increased compared with those in 1 month after treatment (Z=-4.472, -4.025, -4.707, -4.565, -3.994, -4.777, P<0.01); in 12 months after treatment, the independent ability of transferring between beds and chairs, walking, and up and down stairs in the movement items of ADL in patients were significantly increased compared with those in 1 month after treatment (Z=-3.827, -3.358, -3.557, P<0.01). Conclusions: After using the wedge-shaped heel pad, the standing balance ability, ankle joint dorsiflexion range of motion, walking ability are significantly improved, and the independent levels of movement items in ADL are significantly increased in extremely severe burn patients with foot drop deformity .
PMID:33894699 | DOI:10.3760/cma.j.cn501120-20200319-00181
