Pathways of ambulation after lower limb burn injury: Does timing of ambulation influence functional outcome?

Ms Pippa Pienaar3, Dr Dana Hince4, Mr  Aaron  Berghuber5, Mr Paul Gittings2, W. Prof Fiona  Wood2, A.Prof. Dale Edgar1

1Burn Injury Research Node, The University Of Notre Dame Australia, Fremantle, Australia, 2State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Australia, 3School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia, 4Institute of Health Research, The University of Notre Dame Australia, Fremantle, Australia, 5WA Department of Health, Murdoch, Australia


A lower limb burn arguably has a significantly greater effect on return to participation, than does an upper limb burn, due to the detrimental impacts on ambulation and functional capacity. The patterns of functional recovery following a lower limb burn are poorly understood, and only been examined superficially in small cohorts.


A retrospective longitudinal cohort study was instigated to explore lower limb burn patient outcomes between 2011 and 2016. The aims of the study were to determine if the timing of ambulation after injury and after skin grafting influenced: a) the short term outcomes (LOS); and, b) the long term functional outcomes. The latter was measured using the patient responses to the Lower Limb Functional Index (LLFI) at admission (premorbid baseline) and post-burn at six (6) weeks and months three (3), six (6) and 12. The definition of ‘early ambulation’ varies throughout the literature, and for the purposes of this study, four pathways of ambulation were defined.  It was hypothesised that patients ambulating early post burn and surgery would have shorter LOS and improved functional outcomes, returning to pre-injury function faster, compared to those who ambulated later.

Results to date

Sample description: 1250 lower limb burn patients were collated. In this sample, 65 % were male and 58% required surgical intervention. The median TBSA was 1.5% (IQR=3.7%, range = <1 to 73.5%).

Pippa completed this study to fulfil the requirements for an Honours award as part of her Physiotherapy degree.

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