CBM Rehabilitation & Physical Therapy 3 — Questions and Answers
Question 1: A burn patient has a healed dorsal hand burn with MCP joint hyperextension and IP joint flexion. This posture is called the:
- Claw hand deformity (Correct answer)
- Intrinsic plus position
- Wrist drop deformity
- Volkmann contracture
Correct answer: Claw hand deformity
The 'claw hand' or intrinsic-minus position results from dorsal hand burns causing MCP hyperextension and IP flexion due to intrinsic muscle disruption.
Question 2: Which scar characteristic on the Vancouver Scar Scale (VSS) evaluates the color of mature vs. immature burn scars?
- Pliability
- Vascularity (Correct answer)
- Height
- Surface area
Correct answer: Vascularity
The VSS vascularity subscale rates scar color from normal skin tone to purple, reflecting vascularity and scar maturity.
Question 3: During ambulation training for a patient with lower extremity burns and new skin grafts, which precaution is MOST critical in the early post-graft period?
- Avoiding all lower extremity movement for 6 weeks
- Applying ace wraps from distal to proximal before dependent positioning (Correct answer)
- Elevating only the uninvolved extremity
- Removing compression garments during walking sessions
Correct answer: Applying ace wraps from distal to proximal before dependent positioning
Ace wrapping distal to proximal controls edema and venous pooling when the grafted leg is placed in a dependent position during ambulation.
Question 4: What is the role of silicone gel sheeting in burn scar management?
- It delivers topical antibiotics to maturing scars
- It softens and flattens hypertrophic scars through hydration and occlusion (Correct answer)
- It replaces pressure garments for full-thickness burns
- It accelerates re-epithelialization of open wounds
Correct answer: It softens and flattens hypertrophic scars through hydration and occlusion
Silicone gel sheeting reduces scar height and erythema by maintaining a moist, hydrated environment and applying light pressure to the scar surface.
Question 5: A pediatric burn patient has significant anxiety about physical therapy sessions. Which behavior management approach is MOST evidence-supported?
- Withholding therapy until the child is calm
- Distraction techniques such as virtual reality or video games during treatment (Correct answer)
- Increasing sedation prior to every therapy session
- Performing all exercises only while the child is sleeping
Correct answer: Distraction techniques such as virtual reality or video games during treatment
Non-pharmacological distraction methods like virtual reality are evidence-based for reducing procedure-related pain and anxiety in pediatric burn patients.
Question 6: Which plane of motion is MOST restricted by a burn contracture across the antecubital fossa?
- Elbow pronation
- Elbow supination
- Elbow extension (Correct answer)
- Elbow flexion
Correct answer: Elbow extension
Anterior elbow burns scar across the flexor surface, pulling the elbow into flexion and restricting full extension.
Question 7: What is the minimum recommended daily wear time for pressure garments to be therapeutically effective in scar management?
- 4–6 hours
- 8–10 hours
- 23 hours (Correct answer)
- 12 hours
Correct answer: 23 hours
Pressure garments must be worn 23 hours per day (removing only for hygiene and garment washing) to provide sustained compression and effective scar control.
CBM Rehabilitation & Physical Therapy 3
A burn patient has a healed dorsal hand burn with MCP joint hyperextension and IP joint flexion.
This posture is called the: