Frew_2019.pdf (4.74 MB)
Effect of isolated foot burns on gait, lower-limb function and quality of life
thesisposted on 2023-08-30, 18:53 authored by Quentin Frew
Background- Advances in acute care of burns patients has now led to issues of chronic disability and morbidity in those patients who are surviving what were previously considered unsurvivable burns. Much focus has been on hand function and facial aesthetics little has been done to look at the impact of feet burns. Research objectives- This study investigated the functionality and morbidity in the little explored area of burns on the lower limb and the longer-term impact of different treatment options on gait and function. Methods- An ‘isolated feet burns’ and a ‘normal’ population of healthy volunteers were recruited. Both groups were assessed against three outcome groups: a) Standardised questionnaires- To assess the impact on daily life and psychological aspects using: Lower Extremity Functional Scale, Foot Function Index, and SF-36. b) Physiotherapy (1) Power– using Oxford strength scale scoring; (2) Active and passive range of movement–using goniometry; (3) Specialist tests. c) Gait analysis–Conducted in a gait laboratory looking at (a) Temporospatial outcomes, (b) Kinetic data of joint orientation within the gait cycle, and (c) Force plate analysis. Results- 16 patients and 30 controls were recruited. Statistical differences between patients and controls was seen across all three outcome measures demonstrating their significant impacts on patients’ lives. Anatomical subzones of the feet were also analysed to see the effects the areas had on the outcome measures. Analysis comparing treatment options of grafting or conservative management showed in most cases grafting to provide superior results. Conclusions- For the first time the impact of isolated foot burns on patients’ quality of life has been demonstrated. Until now their priority in the reconstructive importance has been low. From this study, a baseline for future research, and interventions can be established. This will enable treatment strategies to be focused on not only wound closure but also improving patient quality of life to be devised.
InstitutionAnglia Ruskin University
- Accepted version