PT/OT Forum, Burn Patient Cooperation in Physical and Occupational Therapy

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Because studies on compliance with physical therapy regimens are apparently nonexistent in the literature, a questionnaire on this subject was sent to 90 burn care facilities in the United States and Canada. The questionnaire was designed to determine those aspects of physical therapy that meet with the least patient compliance, the methods used by therapists to improve cooperation, and which methods seem most successful. The responses indicated that the pediatric age group is least cooperative and that in patients of all ages, compliance is lowest in range of motion and stretching exercises and highest in activities of daily living. Techniques used most commonly by therapists to achieve compliance are: keeping to a regular (consistent) schedule; allowing periods of relaxation; and (surprisingly) use of scare tactics (ie, showing pictures of contractures). Among the psychosocial professionals who can be called upon to help therapists plan strategies for dealing with uncooperative patients, social workers are most often available on a fulltime basis, followed by psychologists and psychiatrists, who were more available on a consultation basis.

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