Keywords
Physiotherapy
Rehabilitation
Treatment Adherence
Adolescents
How to Cite
Abstract
Introduction. Physiotherapy plays a crucial role in the management of pediatric burn patients, requiring early intervention and long-term follow-up to prevent functional limitations and manage scar-related complications. Adolescents represent a particularly challenging group, as developmental, psychological, and social factors may negatively influence engagement and adherence to rehabilitation programs. This study aimed to describe the physiotherapy tools used in pediatric burn patients and to compare physiotherapy modalities and treatment adherence between children and adolescents treated at a tertiary pediatric burn center.
Methods. A retrospective observational, monocentric chart review was conducted in accordance with STROBE guidelines. Medical records of pediatric burn patients (≤18 years) admitted to the Burns Center of Meyer Children’s Hospital IRCCS, Florence, between 2017 and 2022 and managed by the Rehabilitation Unit were reviewed. Patients were divided into two groups based on age at admission: children (<11 years) and adolescents (11-18 years). Data collected included demographic characteristics, burn features, physiotherapy modalities used during the acute and scarring phases, and adherence to the prescribed physiotherapy program. Adherence was assessed subjectively by treating physiotherapists during routine clinical practice. Categorical variables were analyzed using Chi-square or Fisher’s exact tests.
Results. Thirty-five patients were included: 20 children and 15 adolescents. The adolescent group more frequently presented with burns involving a larger total body surface area. Most physiotherapy tools were used similarly in both groups; however, gait training during the acute phase was more frequently applied in adolescents (p = 0.046), while contact media during the scarring phase were more commonly used in children (p < 0.05). Adherence to physiotherapy during hospitalization was generally good in both groups. During the scarring phase, children showed significantly higher adherence to splints, massage combined with skin hydration, elastic-compressive garments, and contact media (all p < 0.05).
Discussion. Physiotherapy management in pediatric burn patients relies on similar tools across age groups; however, adherence appears to be lower in adolescents, particularly during long-term scar management. Developmental factors and family involvement likely play a key role in treatment engagement. These findings highlight the need for age-tailored, patient-centered rehabilitation strategies to improve adherence among adolescents with burn injuries.
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