Survey Participation Using the Snowball Sampling Technique an

Survey Participation • Using the “Snowball Sampling Technique” an attempt was made to acquire an exhaustive list of contact information of Canadian OTs and PTs who dedicated a substantial portion of their clinical practice to burn survivor rehabilitation. • 131 surveys were mailed out (both English and French versions were sent to each person) • 62 participants responded to the survey • 31 participants responded that they no longer actively worked with burn survivors • 8 surveys were returned as “wrong address” • There was no response for 30 surveys

• SECTION 1: Socio-demographics • SECTION 2: Work Environment • SECTION 3: Assessments and Therapeutic Interventions • SECTION 4: Education at Work • SECTION 5: Continuing Education

SECTION 1: Socio-demographics

Socio-demographics Profession

Socio-demographics Gender

Socio-demographics Age

Socio-demographics Preferred Language

Socio-demographics University Education

Socio-demographics Level of Education

Socio-demographics Weekly Work Hours

Socio-demographics Years of Clinical Experience

Socio-demographics Number of Burn Survivors Treated on a Weekly Basis

SECTION 2: Work Environment

Work Environment Types of Work Settings

Work Environment Location of Work Setting

Work Environment Source of Funding of the Work Setting

Work Environment Teaching Institution and Research Within the Work Setting

Work Environment Number of OTs or PTs Who Supervise Students

Work Environment The Number of OT or PT Students Supervised by Each Therapist Per Year

Work Environment Number of Therapists in the Work Setting

Work Environment Use of a Multidisciplinary Team Approach in the Treatment of the Burn Survivors

Work Environment Multidisciplinary Team Members

SECTION 3: Assessments and Therapeutic Interventions

Assessments The following assessment were reported as being typically used

Assessments Additional impairment assessments that were reported as being typically used Pain Dallas Pain Questionnaire 1 Wound Pictures/Observation 5 Mc. Gill Pain Questionnaire 2 Scar Measuring Tape 1 Edema Volumeter 9 Photography 9 Sensation Tuning fork (vibration) 1 Scar depth 2 Pressure 1 Skin Braden Scale 1 Pin prick 1 Flexibility Thomas Test 1 Light touch 1 Atrophy Measuring tape 1 Hot/cold 6 Endurance Bruce Treadmill Test 3 Moberg Test 1 Oxygen Saturation Saturometer 2 Moving 2 -pt discrimination 3 DVT Homan’s Test 1 Grip Strength Rapid exchange 7 ROM Maigne (cervical and lumbar) 3 Perceived Exertion Modified Borg Scale 1

Assessments Additional outcome assessments that were reported as being typically used General Function L/E Function Driving Work Quality of Life Functional Independence Measure 5 COPM 3 Assessment of Motor Process Skills U/E Function Biometrics 8 Smith Hand Function Test 6 1 DASH 5 Timed Up and Go 5 Minnesota Rate of Manipulation 5 10 -meter walking speed test 2 TEMPA 5 FOAM and DOME test 2 Beaded Peg Test 4 2 -minute walk test 2 Nine Hole Peg Test 4 6 -minute walk test 1 Dellon Pinch Test 3 Lower extremity functional scale 1 Jebsen Hand Function Test 3 Automatic Brake Reaction Timer 3 Manipulative Aptitude Test 3 UFOV 1 Grooved Pegboard 2 Valpar 3 Michigan Hand Questionnaire 2 Baltimore Therapeutic Equipment 2 Epic Hand Sort 1 Injured Workers Survey 1 PACT Hand Sort Function Test 1 Short Form Health Survey (SF-36) 1 Patient Rated Wrist and Hand Evaluation 1 Abbreviated Burn Specific Health Scale 1 Mini-Mental State Examination 4 JAS Scale 1 Cognitive Competency Test 2 Scott Scale 1 Cognistat 1 Pain Disability Index 1 Rivermeade Memory 1 Cognitive Function

Therapists were asked to rank the factors that affected their choice of assessment Numbers of Therapists Who Selected Each Ranking Factors affecting choice of assessment Top Ranking 2 nd Reason 3 rd Reason It is available where I work 23 8 10 6 19 6 8 7 11 15 6 6 It is quick and easy to administer It has known reliability and validity for assessment of burn survivors I learned it during my professional training

Therapist were asked “In a perfect world, what assessment would they use? ” Equipment Standardized Assessments/Scales Digital Photography 4 Vancouver Scale 10 Scanner for Orthoses 3 Functional Independence Measure 4 Digital Goniometer 2 CMOP 4 Work Simulator 2 Mc. Gill Pain Scale 3 Volumeter 1 Short Form Health Survey (SF-36) 2 Durometer 1 Braden Scale 2 Isokinetic Assessment Device 1 Michigan Hand Outcome Questionnaire 2 Greenleaf Hand Assessment 1 Sickness Impact Profile 1 TEMPA 1 Assessment of Motor Performance (AMPS) 1 Semmes Weinstein Monofilaments 1 Assessments that do not yet exist A complete, objective, painless scar and skin evaluation 17 A burn specific ADL and IADL assessment 3 Other Work site and return to work assessment 5 No assessments other than those currently used 5

Therapists were asked to rank the barriers that limit their use of desired assessments Numbers of Therapists Who Selected Each Ranking Barriers Top Ranking 2 nd Reason 3 rd Reason Time constraints 15 5 6 9 9 2 5 2 1 3 2 5 Equipment not available Financial constraints Requires special training

Interventions The following interventions were reported as being typically used

Interventions Additional interventions that were reported as being typically used Home Programs 9 Ice 4 Desensitization (vibration, friction) 8 School or work re-entry program 4 Wound Care (cleaning, débridement) 8 Continuous Passive Motion (CPM) machines 3 Joint Mobilization 6 Fine Motor Skill Training 3 Chest Therapy 6 Reversing Hand Dominance Training 3 Biometric Exercises 6 Laser 3 Ultrasound 6 Electrotherapy 2 Relaxation Training 5 Cream 2 Mock Situation Training 5 Exercises for Posture 1 Work Simulation (BTE, Valpar) 5 Carpentry Activities 1 Electronic Muscle Stimulation (EMS) 4 Energy Conservation Techniques 1 Pain Control (distraction) 4

Interventions Duration of a Typical Treatment (Minutes) Frequency of Response 30 2 10 to 180 2 15 -60 3 20 -90 4 30 -45 1 30 -60 9 30 -120 2 45 3 45 to 60 4 45 -90 2 60 14 60 -90 12 60 twice per day (120) 3 180 1

Interventions Number of times per month that the burn survivor would typically receive treatment IN-PATIENT Frequency of Response OUT-PATIENT Frequency of Response 12 to 16 2 1 3 12 to 20 7 1 to 2 1 16 to 20 3 1 to 5 3 Daily (20 to 28 times) 27 2 to 3 4 3 to 5 1 TYPE OF REHAB WAS NOT SPECIFIED 4 to 6 1 4 to 8 3 Depends on patient’s needs 7 4 to 12 2 4 to 20 3 8 to 12 8 12 to 16 3 16 1 20 to 25 2 1/3 months 2

Interventions Total number of weeks that the burn survivor would typically receive treatment IN-PATIENT Frequency of Response OUT-PATIENT Frequency of Response 1 to 8 2 1 to 8 1 1 to 24 6 2 to 104 2 2 to 3 1 3 to 4 3 2 to 4 1 3 to 72 2 4 to 6 1 6 to 10 6 5 1 12 to 26 2 6 1 12 to 52 2 Daily until discharge 3 18 1 24 to 72 4 TYPE OF REHAB WAS NOT SPECIFIED 1 to 104 1 24 to 156 2 1 to 156 1 52 to 104 2 2 to 104 1 52 or more 5 4 to 104 3 6 to 8 1 Depends on the patient’s needs 15

Therapists were asked to rank the factors that affected their choice of interventions Numbers of Therapists Who Selected Each Ranking Factors affecting choice of interventions It has published evidence of effectiveness in treating burn survivors Top Ranking 2 nd Reason 3 rd Reason 17 13 5 17 13 4 I saw it described in a professional textbook or journal that I usually read 1 2 10 Resources required for the intervention are available where I work 16 5 9 I learned it during my professional training

Therapist were asked “In a perfect world, what therapeutic interventions would they use? ” Equipment Modalities Continuous Passive Motion (CPM) Machine 5 Laser 2 Pool Therapy 4 Ultrasound 1 Biometrics 2 Any new modality that would decrease hypertrophic scar 1 JAS Static Progressive Stretch Device 1 Biofeedback 1 Services Work Simulators 1 On Site Pressure Garment Manufacturing 4 Dynasplints 1 More Massage Therapy 4 Increased Community Reintegration Intervention 4 More Psychosocial Support 3 Education More Time for Treatment and Education 6 More Team Members 3 More Coping and Relaxation Strategies for Patients 3 More Available Research 3 More Fitness and Endurance Training 3 Adolescent Support Group 1 Global Postural Education 2 Other Group Hand Class 1 Satisfied with the interventions currently being used 10 Relaxation Training 1 Do not know what else is out there due to a lack of time 6

Therapists were asked to rank the barriers that limit their use of desired interventions Numbers of Therapists Who Selected Each Ranking Barriers Top Ranking 2 nd Reason 3 rd Reason Time Constraints 14 4 9 4 5 1 7 4 Financial Constraints Requires Special Training Equipment Not Available

SECTION 4: Education at Work

Education at Work Support for On-going Professional Learning by the Work Environment

Education at Work Access to New Information on Burn Injuries and Burn Rehabilitation is Easily Available

Education at Work Sources of Information at Work

Education at Work Time Available for Learning at Work and Availability of Funds for Continuing Education 33 52 Time for Learning Continuing Education Yes 29 10 No