温泉療法により四肢拘縮の改善がみられた四肢熱傷の1例

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  • 清水 祥史
    Department of Rehabilitation, Atagawa Rehabilitation Hospital

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タイトル別名
  • Balneotherapy lmproves Limbs Contracture in a Patient with Limbs Burn (A case report)
  • オンセン リョウホウ ニ ヨリ シシ コウシュク ノ カイゼン ガ ミラレタ シシ ネッショウ ノ 1レイ

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 The specific effect of balneotherapy by sulphated salt springs on a 51-year old man with limb contracture induced by limb burns was observed. He underwent a skin graft for two to three degree burns on 30% of his total body surface area involving limbs, and was admitted to Atagawa rehabilitation hospital after traumatism for two months. After he had balneotherapy (sulfated salt springs) for 15 minutes, he received 40 minutes of physical therapy four times a week as well as 40 minutes of occupational therapy four times a week. After treatment for three months, his contracture and daily living activities improved to a complete independence level, at which point he was discharged. He continued rehabilitation through the outpatient department, during which time his contracture worsened at one point before improving again.<br> During his rehabilitation, a difference was recognized in the frequency and content of his rehabilitation during hospitalization compared to that in the outpatient department. He performed voluntary training mainly on range of motion exercises with a positive attitude throughout hospitalization, and the frequency and content of voluntary training did not change much after discharge, but balneotherapy ended with the discharge, so we presume that the improvement of the good range of motion limit during his time as an inpatient and the worsening of this after discharge was due to whether or not he was receiving balneotherapy.<br> For the treatment of hypertrophic scars, a silicone gel sheeting has been used since the 1980s. Silicone gel sheeting is a safe and effective treatment for hypertrophic and keloid scars. Comparing the effects of treatment using silicone gel sheeting to those of treatment using sulphated salt springs shows there are common elements in terms of thermal insulation, moisture retention, action on fibroblast, and acceleration of collagenase activity and production. Therefore, it is expected that treatment using balneotherapy by sulphated salt springs has a similar effect as when treating hypertrophic scars with silicone gel sheeting and suggests why this led to improvement for this ailment. In addition, balneotherapy using sulphated salt springs is expected to provide the benefits of bathing in a sulphatedsalt springs in a convenient and easy manner for the entire body.<br> The authors propose a new rehabilitation method using balneotherapy by sulphated salt springs to treat hypertrophic scaring.

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