Reliability of a novel technique to assess palmar contracture in young children with unilateral hand burns

Ms Rhianydd Thomas1,2, Dr Marita  Dale3, Ms Stephanie Wicks1, Mrs Claire Toose1, Dr Verity Pacey2

1The Children’s Hospital At Westmead, Sydney, Australia, 2Macquarie University, Sydney, Australia, 3The University of Sydney, Sydney, Australia

Abstract:

This novel assessment technique compares hand span and hand length measures from the left and right hands to monitor ROM in the affected hand in young children with unilateral hand burns. The aims of this study were to determine the reliability of hand span and hand length measures in young children and establish whether there is any association with age, sex and presence of a palmar burn injury in the reliability of these measures. The study also sought to determine the normative difference and establish a cut-off value for the difference between the left and right hands to identify loss of movement in one hand. Forty-four children aged 0-<5 years were recruited. Twenty-two of these children had a unilateral palmar burn injury and 22 did not have a palmar burn injury. Each child’s hand span and hand length were measured three times by two assessors and repeated by one assessor. Intraclass correlation coefficients were calculated to determine the inter-rater and intra-rater reliability. The largest of the three values for both hand span and hand length from the first assessor’s first trial were used to determine the normative difference between the left and right hands. Excellent reliability was established for hand span and hand length measures for the whole group (inter-rater ICCs ≥0.94, intra-rater ICCs ≥0.95). The mean normative between-hand difference for both hand span and hand length was 2mm. The cut-off for the normative difference in hand span was <9mm and hand length was <7mm.


Biography:

Rhi is a physiotherapist who works in the Burns Unit at The Children’s Hospital at Westmead. She completed a Master of Research in 2018 investigating outcomes of end of range splinting of the axilla following burn injury in children. In 2019 she commenced a PhD focusing on the role of early and intensive splinting to prevent contracture following palm burns in young children.

Recent Comments