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The major objective of the current paper is to trace and investigate which method is more effective whether the high or the low Transcutaneous electric Nerve Stimulations (TENS) on venous ulcers. A single-blinded, randomized, and controlled trial was done successfully. Sixty venous ulcer patients were divided randomly into three groups; Group (A): control group, Group(B): High-TENS group, and Group(C): Low-TENS group. Group (A), contains twenty participants who received routine medical care and dressing. As for group (B), includes twenty participants who obtained high-frequency TENS; Frequency (80-120) HZ, Intensity (15 - 30 amp), Pulse duration 250 Micro sec, 60 min per session with routine medical care and dressing. The third group (c) L-TENS, encompasses twenty participants who received low-frequency TENS (1-5) HZ; Intensity (30 -80 amp), Pulse duration 250 Micro sec, 60 min per session with routine medical care and dressing. All the participants were examined before and after two months of intervention; four weeks (post1), then after eight weeks (post2). Participants were examined by using (image j) to measure the ulcer area. Saline was used for measuring the ulcer volume, and a visual analog scale was adopted to evaluate pain. After drawing a comparison among the three groups after four weeks and after eight weeks of treatment, a statistically significant decrease (P <0.05) in wound surface area, wound volume, and pain in favor of L-TENS was noticed. It has been found that L- TENS is more effective than H -TENS and is highly recommended in the treatment protocol for such debilitating conditions.

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Severe burn injuries are associated with hypermetabolic response and increased catabolism. These lead to a vast loss of muscle mass and reduced muscle strength and function. Therefore, the aim of this study is to determine the impact of severe burn injuries on lower-limb muscular strength, balance, and mobility level in adults. Forty burned adults with burned TBSA (burned TBSA) ≥40% participated in this study. The peak torque and total work of quadriceps and knee flexors were calculated at 150°/sec using Biodex isokinetic dynamometer. Balance and mobility were tested via the Biodex balance device and the high mobility assessment tool, respectively. Twenty-three matched nonburned healthy adults were evaluated and served as a control group. Severely burned adults exhibited significantly lower peak torque and total work in their quadriceps (27.50 and 22.58%, P < .05) and knee flexors (23.72, and 21.65%, P < .05) relative to the nonburned adults. Burned adults had a significant decrease in stability index and balance including the dynamic limits of stability (P < .05). The high mobility assessment tool scores were significantly lower (42 ± 7.64, P < .05) when compared with control subjects (51 ± 1.62). Patients who had severe burns (burned TBSA ≥ 40%) showed muscular weakness, limited balance, and mobility levels between 16 and 24 weeks after discharge from the hospital compared with matched nonburned control subjects. These results can guide therapists in creating rehabilitation programs that focus on the specific difficulties faced by burned patients.

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INTRODUCTION: Severe burns result in marked and prolonged skeletal muscle catabolism and weakness, which persist despite 'standard" rehabilitation programmes of occupational and physical therapy. Therefore, the objectives of this study were of twofold: to quantify the long-term effects of burns on leg muscle strength and to assess whether adults with thermal burn would benefit from the isokinetic training programme. MATERIALS AND METHODS: Burned adult patients, with 35-55% total body surface area (TBSA) burned, were assessed at 6 months after burn in respect to leg muscle strength at 150° s(-1), using isokinetic dynamometry. Non-burned adults were assessed similarly, and served as controls. The burned adults participated in the resistance training programme 3 times weekly. The isokinetic exercise programme was begun with 60% of the average peak torque. Intensity of isokinetic exercise was increased from one set to five sets during the first through fifth sessions and remained at six sets for the remaining 6th to 24th sessions. Finally, a dose of 10 sets was applied for the 25th to the 36th sessions. Each set consisted of five repetitions of concentric contraction in angular velocities of 150° s(-1) for knee extensors, and flexors. All exercise sessions were preceded by a 5-min warm-up period on the treadmill. RESULTS: Subjects with burns more than 35% of TBSA produced significantly less torque, work, and power in the quadriceps and hamstring than control subjects (20.5%, 15.2%, p<0.05). Three months after isokinetic programme, muscle strength further increased by 17.9%±10.1% compared to the baseline measurement for burned patients but continued to be below the concurrent age-matched, non-burned adult. CONCLUSION: We found that adults with severe burns, relative to non-burned adults, had significantly lower peak torque as well as total work performance using the extensors and flexors muscles of the thigh. Participation in isokinetic training resulted in a greater improvement in extensor and flexor muscle strength in adults with held thermal burn compared to base line values.

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