Effect of Task Oriented Training and Xbox KinectTM on Hand Function in Pediatric Burn (HandBurn)

The Jebsen-Taylor Hand Function Test and Canadian Occupational Performance Measure (COPM) were considered as primary outcome measurements. Secondary outcomes included total active range of motion (ROM) of the digits, hand grip strength and pinch strengths (tip, palmer and lateral pinch). All measurement was conducted at two occasions: at the baseline and after intervention.

Study Overview

• Status: Completed
• Conditions: Burns; Hand Burn
• Intervention / Treatment: Other: control; Other: task oriented training; Other: Xbox kinect

Detailed Description

The included participant were children with a deep partial thickness or a full thickness burn induced by either a scaled or a flame thermal burn with involvement of more than 50% of the hand and wrist, total body surface area (TBSA) less than 30% , age ranged from 7 to 14 years, recent discharge of inpatient acute care, spontaneous healing (within 34 weeks) or grafting with split thickness or full-thickness skin grafts (at least before 2 weeks). Children were excluded from this study if they had infection, juvenile arthritis, fracture, tendon injuries, muscle injury, degenerative joint diseases, peripheral nerve diseases, Pre - established psychologically and physically disorders (extreme aphasia, cognitive and developmental deficits that can influence the rehabilitation).

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 11241
    • Shorook Physical Therapy Centers

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 7 years to 14 years (CHILD)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• children with deep partial thickness or a full thickness burn
• burn induced by either a scaled or a flame thermal burn
• involvement of more than 50% of the hand and wrist
• total body surface area (TBSA) less than 30%
• age ranged from 7 to 14 years
• recent discharge of inpatient acute care
• spontaneous healing (within 34 weeks)
• grafting with split thickness or full-thickness skin grafts (at least before 2 weeks).

Exclusion Criteria:

• children with infection
• juvenile arthritis
• fracture
• tendon injuries
• muscle injury
• degenerative joint diseases
• peripheral nerve diseases
• Pre - established psychologically and physically disorders
• extreme aphasia
• cognitive and developmental deficits that can influence the rehabilitation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: FACTORIAL
• Masking: DOUBLE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: control; The traditional rehabilitation program conducted for 40-min sessions, three times per week for 8 weeks for all children.	Other: control; The traditional therapy included immersing the hand in paraffin for 10 min; soft massaging with a moisturizing gel for 5 min; passive mobilization of the wrist, MP, PIP, and DIP joints; active/passive ROM and stretching exercises; strengthening exercises (done in static mode initially and progressed in the second month to dynamic strengthening using elastic bands); desensitizing sensory stimulation of hypertrophic scars, occupational therapy.
EXPERIMENTAL: task oriented training; Task-oriented training TOT group was conducted with an average of 50-min sessions three times a week for 8 weeks. Baseline Canadian Occupational Performance Measure COPM results were used to generate individualized intervention goals for each participant.	Other: control; The traditional therapy included immersing the hand in paraffin for 10 min; soft massaging with a moisturizing gel for 5 min; passive mobilization of the wrist, MP, PIP, and DIP joints; active/passive ROM and stretching exercises; strengthening exercises (done in static mode initially and progressed in the second month to dynamic strengthening using elastic bands); desensitizing sensory stimulation of hypertrophic scars, occupational therapy.; Other: task oriented training; The traditional plus the target activities involved training with the materials (clothes, spoons, pencils, buttons, rope, etc) needed for the activity as well as Velcro cylinders, skill cubes, exercise bands, screw sets, therapeutic putty, and tripled coordination tools.
EXPERIMENTAL: Xbox kinect; Xbox training group was conducted with an average of 50-min sessions three times a week for 8 weeks. Baseline Canadian Occupational Performance Measure COPM results were used to generate individualized intervention goals for each participant.	Other: control; The traditional therapy included immersing the hand in paraffin for 10 min; soft massaging with a moisturizing gel for 5 min; passive mobilization of the wrist, MP, PIP, and DIP joints; active/passive ROM and stretching exercises; strengthening exercises (done in static mode initially and progressed in the second month to dynamic strengthening using elastic bands); desensitizing sensory stimulation of hypertrophic scars, occupational therapy.; Other: Xbox kinect; The traditional plus Xbox Kinect games were related to five target activities determined according to the person-centered analysis results were chosen for each patient.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Jebsen-Taylor Hand Function Test	is an objective and standard method designed to assess the hand's functional abilities	baseline
Jebsen-Taylor Hand Function Test	is an objective and standard method designed to assess the hand's functional abilities	immediately after the intervention
Duruoz Hand Index	is a self-reported questionnaire developed to assess hand ability in the kitchen, during dressing, while performing personal hygiene and office tasks, and other general items	baseline
Duruoz Hand Index	is a self-reported questionnaire developed to assess hand ability in the kitchen, during dressing, while performing personal hygiene and office tasks, and other general items	immediately after the intervention
Canadian Occupational Performance Measure	is a client centered, occupation-focused outcome measure for the detection of change in perceived occupational performance over time.	baseline
Canadian Occupational Performance Measure	is a client centered, occupation-focused outcome measure for the detection of change in perceived occupational performance over time.	immediately after the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
total active range of motion (ROM) of the digits	The total active ROM was measured by a hand-held steel finger goniometer	baseline
total active range of motion (ROM) of the digits	The total active ROM was measured by a hand-held steel finger goniometer	immediately after the intervention
hand grip strength	Grip strength was assessed using a Jamar hydraulic dynamometer	baseline
hand grip strength	Grip strength was assessed using a Jamar hydraulic dynamometer	immediately after the intervention
pinch strength	pinch strengths (tip, palmer and lateral pinch) were assessed using a pinch dynamometer	baseline
pinch strength	pinch strengths (tip, palmer and lateral pinch) were assessed using a pinch dynamometer	immediately after the intervention

Collaborators and Investigators

• Sponsor: Qassim University
• Collaborators: Cairo University
• Investigators: Principal Investigator: Maged Basha, PhD, Qassim University

Publications and helpful links

General Publications

• Parry I, Painting L, Bagley A, Kawada J, Molitor F, Sen S, Greenhalgh DG, Palmieri TL. A Pilot Prospective Randomized Control Trial Comparing Exercises Using Videogame Therapy to Standard Physical Therapy: 6 Months Follow-Up. J Burn Care Res. 2015 Sep-Oct;36(5):534-44. doi: 10.1097/BCR.0000000000000165.
• Voon K, Silberstein I, Eranki A, Phillips M, Wood FM, Edgar DW. Xbox Kinect based rehabilitation as a feasible adjunct for minor upper limb burns rehabilitation: A pilot RCT. Burns. 2016 Dec;42(8):1797-1804. doi: 10.1016/j.burns.2016.06.007. Epub 2016 Jul 9.
• Kamel FAH, Basha MA. Effects of Virtual Reality and Task-Oriented Training on Hand Function and Activity Performance in Pediatric Hand Burns: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2021 Jun;102(6):1059-1066. doi: 10.1016/j.apmr.2021.01.087. Epub 2021 Feb 20.

Study record dates

Study Major Dates

• Study Start (ACTUAL): May 1, 2018
• Primary Completion (ACTUAL): September 20, 2019
• Study Completion (ACTUAL): September 20, 2019

Study Registration Dates

• First Submitted: July 24, 2020
• First Submitted That Met QC Criteria: July 29, 2020
• First Posted (ACTUAL): August 4, 2020

Study Record Updates

• Last Update Posted (ACTUAL): August 4, 2020
• Last Update Submitted That Met QC Criteria: July 29, 2020
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Keywords: Hand Function; Grip strength; children burns; pinch strength; Jebsen-Taylor Hand Function Test; Duruoz Hand Index; Canadian Occupational Performance Measure
• Additional Relevant MeSH Terms: Wounds and Injuries; Burns
• Other Study ID Numbers: 2694PT

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data that underlie the results reported in this article, after de-identification (text, tables,and figures)
• IPD Sharing Time Frame: Immediately following publication.
• IPD Sharing Access Criteria: IPD will be available upon reasonable request by email from the main author after revising the requester qualification relevance to the topic of the study and approval of all co-authors within 1 month of receiving the request.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No