Survey Participation

• Using the “Snowball Sampling Technique” an attempt was made to acquire an exhaustive list of contact information of Canadian OTs and PTs who dedicated a substantial portion of their clinical practice to burn survivor rehabilitation.

• 131 surveys were mailed out (both English and French versions were sent to each person)

• 62 participants responded to the survey• 31 participants responded that they no longer actively

worked with burn survivors• 8 surveys were returned as “wrong address”• There was no response for 30 surveys

• SECTION 1: Socio-demographics

• SECTION 2: Work Environment

• SECTION 3: Assessments and Therapeutic

Interventions

• SECTION 4: Education at Work

• SECTION 5: Continuing Education

SECTION 1: Socio-demographics

38

24

OT

PT

Socio-demographicsProfession

58

4

Female

Male

Gender

Socio-demographics

10

25

15

11

1

20-29

30-39

40-49

50+

No response

Socio-demographicsAge

39

16

7

English French No response

Preferred Language

Socio-demographics

Socio-demographicsUniversity Education

1

1

1

2

2

4

4

4

4

5

5

6

7

7

9

Queens University

University of Saskatchewan

Ottawa University

McGill University

No response

Dalhousie University

University of British Columbia

University of Western Ontario

Foreign University

McMaster University

University of Toronto

University of Alberta

University of Manitoba

Laval University

University of Montreal

57

3 02

Bachelor's Degree

Master's Degree

Diploma

Doctorate

Socio-demographicsLevel of Education

44

18

Full-time

Part-time

Socio-demographicsWeekly Work Hours

4

13

21

24

< 1

1 to 3

4 to 10

> 10

Socio-demographicsYears of Clinical Experience

16

21

14

11

< 2

2 to 5

6 to 10

> 10

Number of Burn Survivors Treated on a Weekly Basis

Socio-demographics

SECTION 2: Work Environment

2

16

18

22

26

Other

Rehabilitation In-patient

Acute care Hospital Out-patient

Rehabilitation Out-patient

Acute care Hospital In-patient

Types of Work Settings

Work Environment

62

0

Urban

Rural

Location of Work Setting

Work Environment

48

4

2

8

Public

Private Not For Profit

Private For Profit

Other

Work EnvironmentSource of Funding of the Work Setting

Work EnvironmentTeaching Institution and Research Within the Work

Setting

59

43

32

3

13

21

06

9

0

10

20

30

40

50

60

70

TeachingInstitution

Research Rehab.Research

Yes

No

I don't know

62

0

Participated

Did Not Participate

Work EnvironmentNumber of OTs or PTs Who Supervise Students

0

49

3

10

> 5 Students

1-2 Students

3-5 Students

No Students

Work EnvironmentThe Number of OT or PT Students Supervised

by Each Therapist Per Year

10

4

12

22

9

11

16

21

1 PT

1 OT

2-4 PT

2-4 OT

5-10 PT

5-10 OT

> 10 PT

> 10 OT

Work EnvironmentNumber of Therapists in the Work Setting

46

16

Yes

No

Work EnvironmentUse of a Multidisciplinary Team Approach

in the Treatment of the Burn Survivors

Work EnvironmentMultidisciplinary Team Members

4

6

7

12

17

20

22

24

26

32

35

38

48

51

51

56

58

59

Microbiologist

Family Physician

Intensivist

Special Educator

Massotherapist

General Surgeon

Infection Specialist

Case Manager

Physiatrist

Other

Speech Therapist

Psychologist

Dietician

Social Worker

Plastic Surgeon

Nurse

PT

OT

SECTION 3: Assessments and

Therapeutic Interventions

Assessments

10

10

10

11

13

20

23

25

28

31

54

Berg Balance Scale

Semmes-Weinstein Monofilaments

Numeric Pain Rating Scale

Purdue Peg Board

Measuring Tape (edema)

Visual Analogue Scale (pain)

Pinch Meter

Vancouver Scar Scale

Manual Muscle Testing

Dyanometer

Goniometry

The following assessment were reported as being typically used

Assessments

Pain Dallas Pain Questionnaire 1 Wound Pictures/Observation 5

McGill Pain Questionnaire 2 Scar Measuring Tape 1

Edema Volumeter 9 Photography 9

Sensation Tuning fork (vibration) 1 Scar depth 2

Pressure 1 Skin Braden Scale 1

Pin prick 1 Flexibility Thomas Test 1

Light touch 1 Atrophy Measuring tape 1

Hot/cold 6 Endurance Bruce Treadmill Test 3

Moberg Test 1 Oxygen Saturation Saturometer 2

Moving 2-pt discrimination 3 DVT Homan’s Test 1

Grip Strength Rapid exchange 7 ROM Maigne (cervical and lumbar) 3

Perceived Exertion Modified Borg Scale 1

Additional impairment assessments that were reported as being typically used

AssessmentsGeneral Function

Functional Independence Measure 5 U/E Function

Biometrics 8

COPM 3 Smith Hand Function Test 6

Assessment of Motor Process Skills 1 DASH 5

L/E Function Timed Up and Go 5 Minnesota Rate of Manipulation 5

10-meter walking speed test 2 TEMPA 5

FOAM and DOME test 2 Beaded Peg Test 4

2-minute walk test 2 Nine Hole Peg Test 4

6-minute walk test 1 Dellon Pinch Test 3

Lower extremity functional scale 1 Jebsen Hand Function Test 3

Driving Automatic Brake Reaction Timer 3 Manipulative Aptitude Test 3

UFOV 1 Grooved Pegboard 2

Work Valpar 3 Michigan Hand Questionnaire 2

Baltimore Therapeutic Equipment 2 Epic Hand Sort 1

Injured Workers Survey 1 PACT Hand Sort Function Test 1

Quality of Life Short Form Health Survey (SF-36) 1 Patient Rated Wrist and Hand Evaluation 1

Abbreviated Burn Specific Health Scale 1 Cognitive Function

Mini-Mental State Examination 4

JAS Scale 1 Cognitive Competency Test 2

Scott Scale 1 Cognistat 1

Pain Disability Index 1 Rivermeade Memory 1

Psychosocial Carroll Test 3 Woodcock Johnson 1

Additional outcome assessments that were reported as being typically used

Therapists were asked to rank the factors that affected their choice of assessment

Numbers of Therapists Who Selected Each Ranking

Factors affecting choice of assessment Top Ranking 2nd Reason 3rd Reason

It is available where I work

23 8 10

It is quick and easy to administer

6 19 6

It has known reliability and validity for assessment of burn survivors 8 7 11

I learned it during my professional training

15 6 6

Therapist were asked “In a perfect world, what assessment would they use?”

Equipment Standardized Assessments/Scales

Digital Photography 4 Vancouver Scar Scale 10

Scanner for Orthoses 3 Functional Independence Measure 4

Digital Goniometer 2 CMOP 4

Work Simulator 2 McGill Pain Scale 3

Volumeter 1 Short Form Health Survey (SF-36) 2

Durometer 1 Braden Scale 2

Isokinetic Assessment Device 1 Michigan Hand Outcome Questionnaire 2

Greenleaf Hand Assessment 1 Sickness Impact Profile 1

TEMPA 1 Assessment of Motor Performance (AMPS) 1

Semmes Weinstein Monofilaments 1

Assessments that do not yet exist

A complete, objective, painless scar and skin evaluation

17

A burn specific ADL and IADL assessment 3 Other

Work site and return to work assessment 5 No assessments other than those currently used

5

Therapists were asked to rank the barriers that limit their use of desired assessments

Numbers of Therapists Who Selected Each Ranking

Barriers Top Ranking 2nd Reason 3rd Reason

Time constraints

15 5 6

Equipment not available

9 9 2

Financial constraints

5 2 1

Requires special training

3 2 5

Interventions

11

12

12

13

14

14

14

15

15

20

24

26

28

34

34

35

36

51

Psychosocial Support and Conselling (body image, sexuality)

Heat (Hot packs, moist heat)

Cardiovascular and Endurance Training (Stationary bike, treadmill)

Silicone Gel Therapy

Paraffin Wax Bath

Adaptative Devices (Wheelchair)

Community Resources (Support groups, community programs)

Hydrotherapy (Contrast baths, w hirlpool)

Positioning Techniques

Edema Management (Compression therapy)

Mobilization (Gait training, stairs, transfers, parallel bars)

Stretching Exercises (PNF, manual)

Education (Patients, family and friends)

Strengthening (Manual resistance, w eights)

ADLand IADL Re-training and Functional Activities

Splinting and Orthotic Interventions

ROM Exercises (PROM, AAROM, AROM)

Scar Management (Pressure therapy and inserts, massage)

The following interventions were reported as being typically used

Interventions

Home Programs 9 Ice 4

Desensitization (vibration, friction) 8 School or work re-entry program 4

Wound Care (cleaning, débridement) 8 Continuous Passive Motion (CPM) machines 3

Joint Mobilization 6 Fine Motor Skill Training 3

Chest Therapy 6 Reversing Hand Dominance Training 3

Biometric Exercises 6 Laser 3

Ultrasound 6 Electrotherapy 2

Relaxation Training 5 Cream 2

Mock Situation Training 5 Exercises for Posture 1

Work Simulation (BTE, Valpar) 5 Carpentry Activities 1

Electronic Muscle Stimulation (EMS) 4 Energy Conservation Techniques 1

Pain Control (distraction) 4

Additional interventions that were reported as being typically used

Interventions

Duration of a Typical Treatment (Minutes) Frequency of Response

30 2

10 to 180 2

15-60 3

20-90 4

30-45 1

30-60 930-120 2

45 3

45 to 60 4

45-90 2

60 14

60-90 1260 twice per day (120) 3

180 1

InterventionsNumber of times per month that the burn survivor would typically receive treatment

IN-PATIENTFrequency of

Response OUT-PATIENTFrequency of

Response

12 to 16 2 1 3

12 to 20 7 1 to 2 1

16 to 20 3 1 to 5 3

Daily (20 to 28 times) 27 2 to 3 4

    3 to 5 1

TYPE OF REHAB WAS NOT SPECIFIED  

  4 to 6 1

  4 to 8 3

Depends on patient’s needs  7  4 to 12 2

    4 to 20 3

    8 to 12 8    12 to 16 3

    16 1

    20 to 25 2

    1/3 months 2

InterventionsIN-PATIENT Frequency of

ResponseOUT-PATIENT Frequency of

Response

1 to 8 2 1 to 8 1

1 to 24 6 2 to 104 2

2 to 3 1 3 to 4 3

2 to 4 1 3 to 72 2

4 to 6 1 6 to 10 65 1 12 to 26 2

6 1 12 to 52 2

Daily until discharge 3 18 1

TYPE OF REHAB WAS NOT SPECIFIED 24 to 72 4

1 to 104 1 24 to 156 2

1 to 156 1 52 to 104 2

2 to 104 1 52 or more 5

4 to 104 3

6 to 8 1

Depends on the patient’s needs 15

Total number of weeks that the burn survivor would typically receive treatment

Therapists were asked to rank the factors that affected their choice of interventions

Numbers of Therapists Who Selected Each Ranking

Factors affecting choice of interventions Top Ranking 2nd Reason 3rd Reason

It has published evidence of effectiveness in treating burn survivors 17 13 5

I learned it during my professional training

17 13 4

I saw it described in a professional textbook or journal that I usually read 1 2 10

Resources required for the intervention are available where I work 16 5 9

Therapist were asked “In a perfect world, what therapeutic interventions would they use?”

Equipment Modalities

Continuous Passive Motion (CPM) Machine 5 Laser 2

Pool Therapy 4 Ultrasound 1

Biometrics 2 Any new modality that would decrease hypertrophic scar 1

JAS Static Progressive Stretch Device 1

Biofeedback 1 Services

Work Simulators 1 On Site Pressure Garment Manufacturing 4

Dynasplints 1 More Massage Therapy 4

Increased Community Reintegration Intervention 4

Education More Psychosocial Support 3

More Time for Treatment and Education 6 More Team Members 3

More Coping and Relaxation Strategies for Patients 3 More Available Research 3

More Fitness and Endurance Training 3 Adolescent Support Group 1

Global Postural Education 2 Other

Group Hand Class 1 Satisfied with the interventions currently being used 10

Relaxation Training 1 Do not know what else is out there due to a lack of time 6

Therapists were asked to rank the barriers that limit their use of desired interventions

Numbers of Therapists Who Selected Each Ranking

Barriers Top Ranking 2nd Reason 3rd Reason

Time Constraints

14 4 4

Financial Constraints

4 9 4

Requires Special Training

5 1 5

Equipment Not Available

1 7 4

SECTION 4: Education at Work

3

59

Yes

No

Support for On-going Professional Learningby the Work Environment

Education at Work

10

52

Yes

No

Education at WorkAccess to New Information on Burn Injuries and

Burn Rehabilitation is Easily Available

7

18

19

26

42

51

55

Other

Burn Journal

Journal Club

Workshops

Library

Journal of Burn Care andRehabilitation

Internet

Education at WorkSources of Information at Work

Education at WorkTime Available for Learning at Work

and Availability of Funds for Continuing Education

52

10

29

33

Yes

No

Time forLearning

ContinuingEducation

SECTION 5: Continuing Education

7

3

12

25

6

6

3

1

No response

0 Hours

1 to 2 Hours

3 to 5 Hours

6 to 8 Hours

9 to 11 Hours

20 to 24 Hours

30 Hours

Continuing EducationNumber of Hours per Month Spent on

Continuing Education Activities

10

52Yes

No

Continuing EducationNumber of Therapists Who Have Specialty Certification

23

39

Yes

No

Continuing EducationNumber of Therapists Actively Teaching

at the University Level

1 1

60

Yes

No

Maybe

Continuing EducationA Website Specifically Dedicated to Burn Survivor Rehabilitation in

Canada would be a Useful Learning Tool?