A prospective randomized controlled study of the effects of balance training combined with routine training on patients with lower limb motor and balance dysfunction after severe burns

Objective To observe the effects of balance training combined with routine training on patients with lower limb motor and balance dysfunctions after severe burns. Methods A prospective randomized controlled study was conducted. From January 2016 to January 2020, sixty-four patients with lower limb motor and balance dysfunction after severe burns who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University＆Wuhan Third Hospital. According to the random number table, the patients were divided into routine training (RT) group and combined training (CT) group. There were 32 cases in each group, 22 males and 10 females in RT group, aged 40.5 (35.5, 52.8) years, and 24 males and 8 females in CT group, aged 37.0 (30.0, 44.0) years. Patients in RT group performed conventional treatment including knee joint stretch, continuous passive motion, lower limb muscle strength training, and pressure therapy etc., while patients in CT group received balance training in addition to RT treatment including sitting balance, center of gravity transfer, pelvic stability, standing alternately on one leg, and standing on balance pad. Patients in both groups were treated for 4 months. Before treatment and after 4 months of treatment, the Berg Balance Scale, Lower Extremity Function Scale, and Activities-specific Balance Confidence Scale were used to evaluate the balance function, lower limb function, and balance activity self-confidence of patients respectively. Data were statistically analyzed with independent sample

test, paired sample

test, Mann-Whitney

test, Wilcoxon signed rank test or chi-square test. Results Before treatment, the Berg balance score of patients in RT group was (25±9) points, which was similar to (25±7) points in CT group (

=-0.154,

>0.05). After 4 months of treatment, the Berg balance score of patients in CT group was (43±6) points, which was significantly higher than (40±6) points in RT group (

=2.028,

<0.05). The Berg balance scores of patients in RT and CT groups after 4 months of treatment were obviously higher than those before treatment (

=-15.189, -26.200,

<0.01). Before treatment, the lower limb function score of patients in RT group was 25.0 (16.5, 30.0) points, which was similar to 23.0 (10.3, 28.8) points in CT group (

=-1.575,

>0.05). After 4 months of treatment, the lower limb function score of patients in CT group was 55.0 (35.0, 60.0) points, which was significantly higher than 43.0 (36.0, 53.0) points in RT group (

=-2.744,

<0.01). The lower limb function scores of patients in RT and CT groups after 4 months of treatment were obviously higher than those before treatment (

=-4.943, -4.955,

<0.01). Before treatment, the balance activity self-confidence scores of patients in the two groups were similar (

=-0.966,

>0.05). After 4 months of treatment, the balance activity self-confidence scores of patients in CT group was significantly higher than that in RT group (

=3.343,

<0.01). The balance activity self-confidence scores of patients in RT and CT groups after 4 months of treatment were obviously higher than those before treatment (

=-19.611, -34.300,

<0.01). Conclusions Conventional treatment combined with balance training for patients with lower limb motor and balance dysfunctions after severe burns can effectively promote the recovery of their lower limb motor and balance function.