Joint Range of Motion

Specific Aim #1: To establish the relationship between joint position and skin recruitment,
expressed as the percentage of CFU recruited during active ROM, in patients with burn scars
and normal controls.

Specific Aim #2: To establish the within-day and between-day reliability of percent CFU
estimation and absolute skin recruitment, measured in millimeters from a fixed reference,
during active ROM for a specified joint.

Specific Aim #3: To establish the relationship between scar height, measured by diagnostic
ultrasound, scar cross-sectional area, and percent CFU recruitment in individuals with burn
scar.

Specific Aim #4: To determine whether the amount of skin recruitment, expressed as the
percent of the CFU recruited during active ROM, is differentially affected by burn scar.

Ho: There is no difference in the percent CFU recruited at the completion of active range of
motion at a specified joint between individuals with burn scars and normal controls.

Ha: Individuals with burn scars recruit a greater percentage of the CFU in order to obtain
maximal range of motion at a specified joint.

Specific Aim #5: To determine whether the timing of skin recruitment, expressed as the
initiation of skin movement within a CFU relative to joint position during active ROM, is
differentially affected by burn scar.

Ho: There is no difference in the initiation of skin movement within a CFU relative to joint
position during active ROM at a specified joint between individuals with burn scars and
normal controls.

Ha: In individuals with burn scars in a given CFU, skin movement farther from the joint
axis occurs earlier in the range of motion compared to controls.

Specific Aim #6: To determine whether skin extensibility within a CFU during active ROM of a
specified joint is differentially affected by burn scar.

Ho: There is no difference skin extensibility within a CFU during active ROM of a specified
joint between individuals with burn scars and normal controls.

Ha: In individuals with burn scars in a given CFU, skin near the joint axis undergoes
greater deformation (stretch) as range of motion at the joint increases compared to
controls.

Inclusion Criteria:

- Inclusion Criteria include: 1) male or female burn survivors between the ages of 18
and 60, 2) an area of scar covering at least fifty percent of the CFU of interest, 3)
control subjects must have full active range of motion of the metacarpal phalangeal
joints, wrist and elbow according to published normative references and be free of
any history neuromusculoskeletal injury within the last three years that involved the
joints of interest.

Exclusion Criteria:

- Exclusion Criteria include: 1)burn survivors with an area of scar of less than fifty
percent of the CFU of interest, 2) burn survivors with a history of orthopedic trauma
to the upper extremity (i.e. sprain within the last 24 months, history of fracture,
or history of joint dislocation), 3) control subjects with a history of upper
extremity trauma or injury, 4) control subjects with the presence of scar tissue
covering an area of more than one percent of the CFU of interest, 5) any potential
subject with a history or rheumatoid arthritis, osteoarthritis affecting the
extremity of interest, peripheral nerve injury of the extremity of interest, or
systemic disorder affecting joint range of motion of the upper extremity.