Traumatic burn injuries may lead to restricted joint range of motion, skin contracture (tightening of the skin after a second or third-degree burn), loss of muscle strength, decreased exercise capacity and overall functional decline. Physical activity, including mobility and structured exercise participation, is recommended as an essential component of the burn rehabilitation phase to prevent these complications.

Physiotherapist Anita Plaza, the Royal Brisbane and Women's Hospital (RBWH) Team Leader for Burns, and her team identified key barriers, enablers, and suggestions from both patient and staff perspectives to improve physical activity in the RBWH Professor Stuart Pegg Adult Burns Centre.

Despite a strong rehabilitation focus in the centre, the team has observed low physical activity participation by adult patients hospitalised after burn injuries. It is important to understand what factors (including environmental, system and person-specific factors) contribute to low physical activity participation.

Interviews with patients and clinicians were conducted to identify particular themes related to physical activity during recovery from burns injury. Many enablers and berries emerged and differed between patients and clinicians.

Significant barriers highlighted were the pain and appropriate management, the patient’s understanding of the healing process and need for physical activity, and the burden of burn management procedures.

Strong enablers mentioned were family support and presence during the hospitalisation period, peer support and having access to the external environment and time out of the centre for ‘fresh air’.

Multi-focal solutions have been developed to reduce the barriers to activity participation in the centre, with planned additional education sessions with the multidisciplinary burns team staff to generate an improved understanding of the acute trauma response each patient may experience.

The proposed improvements to physiotherapist participation will encourage and support patients to be more active throughout their hospital stay.