Functional Outcomes in Patients with Hand Burns Receiving Long-Term Occupational Hand Therapy: A Burn Unit's 10-Year Experience.

The hand is the most commonly burned region and often leads to unique functional limitations. Here, we review the associations of long-term outpatient hand therapy (HT) on hand joint range of motion (ROM), activities of daily living (ADL) status, pain, and ability to return to work after burn injury. Adult patients with hand burns admitted to a single American Burn Association-verified burn center from January 2015 to June 2024, with properly documented outpatient HT follow-up, were included. 86 patients were identified who consistently presented for outpatient OT. 75.6% (n = 65) demonstrated improvement of ADL function, and 72.1% (n = 62) had improvement of ROM. At OT intake, 50% (n = 43) reported pain as a major limitation, but by the end of therapy, only 23% (n = 20) were limited by pain. Those with pre-existing hand pathology and older age were more likely to complete therapy to completion (OR = 1.52 and 1.01, CI, 1.1-2.2 and 1.1-1.7, P = .02 for both), and those who did not require surgery and had good compliance as rated by therapists had significantly increased likelihood of ROM improvement (OR = 1.26 and 1.27, CI, 1.0-1.6 and 1.0-1.6, P = .03 and .04). Most patients referred for HT after burn injury return to functional independence and have functional ROM. Further research should take a prospective approach to evaluate the efficacy of hand occupational therapy after burns, focusing on a wider range of functional and psychosocial outcomes.