ABSTRACT
The current evidence to support the use of massage for scar management is conflicting in the literature. The purpose of this study was to compare two scar massage protocols administered with pediatric burn survivors to determine if a more structured and standardized approach to scar massage could improve outcome. A retrospective review of the medical records of 100 children who received massage during the time period when two different protocols were implemented was conducted and data that was collected as part of the clinical exam regarding scar height, vascularity, pliability, itch and pain were extracted. Comparisons were made within subject for scar changes from baseline to follow up and between subjects receiving Protocol A and those receiving Protocol B for the same scar characteristics. Versions of the Vancouver Scar Scale were used to assess scars, while visual analogue scale, Itch Man Scale and Wong-Baker Faces Pain Scale were used to assess itch and pain. Results demonstrated improvements in itch and vascularity over time with both scar massage protocols. However, when comparing patients who received Protocol A to those who received Protocol B, there was no difference found in scar height, vascularity, pliability, itch or pain. Using commonly applied subjective scar assessment tools, we did not find clinically meaningful changes in scar characteristics with the implementation of a structured scar massage program compared to a general approach to massage. Further research is needed to better define the impact of massage on the recovery experience for burn survivors.
Subject(s)
Burns/therapy , Cicatrix/therapy , Massage/standards , Survivors/psychology , Burns/physiopathology , Child , Child, Preschool , Cicatrix/physiopathology , Clinical Protocols/standards , Female , Humans , Male , Massage/methods , Massage/statistics & numerical data , Pain Measurement/methods , Pediatrics/methods , Pediatrics/statistics & numerical data , Retrospective Studies , Survivors/statistics & numerical data , Visual Analog ScaleABSTRACT
La miotonía congénita es la forma más común de miotonía no distrófica. Esta miopatía está causada por mutaciones en el gen CLCN1, codificante del principal canal de iones cloruro del músculo esquelético (ClC-1); la alteración de la función de este canal, regulado por voltaje, da lugar al fenómeno de miotonía. La enfermedad se puede heredar con un tipo de herencia dominante (enfermedad de Thomsen) o recesiva (enfermedad de Becker o miotonía congénita generalizada). El fenotipo clínico de ambas formas de la enfermedad es similar aunque la forma recesiva se caracteriza por una mayor gravedad de los síntomas. El diagnóstico clínico de miotonía congénita debe sospecharse cuando encontramos en un paciente episodios de rigidez muscular (miotonía), remisión o alivio de la rigidez con el ejercicio (fenómeno warm-up), miotonía clínica, un patrón electromiográfico característico y/o historia familiar. El diagnóstico molecular de miotonía congénita consiste en el análisis por secuenciación del gen CLCN1 (AU)
Myotonia congenita is the most common form of non-dystrophic myotonia. This myopathy is caused by mutations in the CLCN1 gene, encoding the main skeletal muscle chloride ion channel (ClC-1). Altering the function of this voltage-gated channel, leads to the phenomenon of myotonia. The disease can be inherited with a dominant (Thomsen disease) or recessive type (Becker disease or congenital generalised myotonia). The clinical phenotype of both forms of the disease is similar, although the recessive form is characterised by more severe symptoms. The clinical diagnosis of congenital myotonia should be suspected in a patient who presents with episodes of muscle stiffness (myotonia), remission or relief from stiffness with exercise (warm-up phenomenon), and a characteristic electromyography pattern, and/or family history. Sequencing the CLCN1 gene is the present approach for molecular diagnosis of myotonia congenita (AU)