A Randomized Controlled Trial of Home-Based Virtual Rehabilitation to Improve Adherence to Prescribed Home Therapy after Burn Injury: A Northwest Regional Burn Model System Trial.

Autor:	Sibbett SH; Department of Surgery, University of Washington, Seattle, WA, USA., Carrougher GJ; Department of Surgery, University of Washington, Seattle, WA, USA., Orton CM; Department of Surgery, University of Washington, Seattle, WA, USA., Sabel JI; Harborview Medical Center, Seattle, WA, USA., Terken T; Harborview Medical Center, Seattle, WA, USA., Humbert A; Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA., Bunnell A; Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA., Gibran NS; Department of Surgery, University of Washington, Seattle, WA, USA., Pham TN; Department of Surgery, University of Washington, Seattle, WA, USA., Stewart BT; Department of Surgery, University of Washington, Seattle, WA, USA.
Jazyk:	angličtina
Zdroj:	Journal of burn care & research : official publication of the American Burn Association [J Burn Care Res] 2024 Aug 27. Date of Electronic Publication: 2024 Aug 27.
DOI:	10.1093/jbcr/irae166
Abstrakt:	Daily rehabilitation after burn injury is vital for prevention of function-limiting contractures. However, adherence to prescribed therapy following acute burn hospitalization has historically been low and not well-studied. Studies involving virtual reality technology have demonstrated an association with improved functional outcomes in burn therapy. We conducted a five-year randomized controlled trial comparing 12 weeks of a home-based virtual rehabilitation (HBVR) system with standard burn therapy. Our primary outcome was adherence to prescribed home therapy, measured by e-diary self-report. Secondary outcomes included steps walked daily and patient-reported outcomes regarding stiffness, upper extremity function, and mobility. We enrolled 50 subjects, of which 48 provided data for analysis (23 HBVR, 25 control). Overall adherence to prescribed home therapy was low, 37.2% in the HBVR group and 60.0% in the control group. Reasons for non-adherence in the HBVR group included lack of time, engagement, and replacement of therapy with other physical activity. However, some subjects enjoyed HBVR and believed it aided their recovery. There was no difference in daily steps walked between the two groups. Daily walking gradually improved from 3,500 steps per day in the first week after baseline and plateaued at 6,000 steps per day at week five. There were no differences in stiffness, upper extremity function, and mobility between the two groups at baseline and 3-, 6-, and 12-month follow-up. Subjects demonstrated improved upper extremity function and mobility in the first year after discharge that coincided with increasing stiffness. (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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