Evidence on contracture prevention and functional recovery in adults with major burns: A narrative review
DOI:
https://doi.org/10.62827/fb.v27i8.1296Keywords:
Cicatrix; Exercise Therapy; Range of Motion; Activities of Daily Living; Burns.Abstract
Introduction: Rehabilitation of adults with extensive or deep burns requiring specialized care must balance tissue protection and restoration of movement. Objective: To examine evidence on scar contracture prevention and functional recovery in this population. Methods: A narrative review was conducted using PubMed searches updated through September 19, 2026, complemented by reference screening, targeted web searches, and consultation of scientific society guidelines. Study-specific severity criteria were preserved, and evidence from distinct populations was treated as indirect. Publications from 2021 to 2026 were prioritized, while relevant earlier sources were retained. Results: Positioning, mobility exercises, and orthoses are components of specialized care, although the magnitude of their preventive effect remains poorly defined. Evidence on pressure garments and silicone is uncertain for scar outcomes and, in most studies, did not directly assess prevention of joint contractures. Massage findings differed according to outcome and follow-up. Trials in adults with extensive burns identified exercise benefits for muscle outcomes or aerobic capacity, with variable transfer to quality of life. Contractures at discharge were associated with lower return to work. Improvements in scar appearance, joint range of motion, and strength do not automatically represent restored independence. Injury severity, graft condition, comparator, and study population modify the interpretation of benefits. Conclusion: The evidence supports integrating preservation of mobility, progressive exercise, and functional training with tissue protection and follow-up after discharge. The ability of individual interventions to prevent contractures and secure social reintegration remains uncertain.
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Copyright (c) 2026 Rafael Viana dos Santos Coutinho, Gabriela Martins Moraes, Guilherme Fernandes Lopes de Almeida, Igor Parada Marangoni, Larissa Luiza Lobo Silva (Autor)
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