Impact of Resistance Training with and without Venous Occlusion on Strength and Function Post Hand Burn: An Open-Label Randomized Controlled Trial

Abstract

Background: Hand burns result in substantial deficits in muscle strength, dexterity, and functional independence, making effective rehabilitation essential. Resistance exercise is a key component of post-burn recovery; however, conventional training is often constrained by the high mechanical loads required. Blood flow restriction (BFR) training has emerged as a potential adjunct that promotes neuromuscular adaptations at lower loads. Methods: This open-label randomized controlled trial included 34 patients with second- and third-degree hand burns after complete wound healing, randomly allocated to two groups. Group A (n = 17) received conventional therapy combined with handgrip resistance training without venous occlusion, while Group B (n = 17) received conventional therapy combined with handgrip resistance training under venous occlusion (60 mmHg cuff pressure, 60% maximal voluntary contraction, 20 minutes/session, three sessions/week for four weeks). Primary outcome was hand grip strength measured using an electronic dynamometer. Upper limb function assessed with the QuickDASH questionnaire was the secondary outcome. Results: Both groups showed significant post-intervention improvements in grip strength and QuickDASH scores (p < 0.001). Group A improved grip strength by 138.65% and QuickDASH by 48.93%, whereas Group B achieved gains of 178.46% and 64.85%, respectively. Between-group comparisons revealed significantly superior outcomes in Group B for both grip strength and function (p < 0.01). Conclusion: Resistance training effectively improves hand strength and function following burn injury, with venous occlusion providing additional benefits. BFR is a clinically relevant adjunct to post-burn rehabilitation after wound closure, enhancing recovery while reducing mechanical load demands.