Non-Invasive Vagus Nerve Stimulation in Patients With Acute Burn Injuries

Burn injuries may trigger a systemic inflammatory response and lead to impaired functional recovery. Non-invasive auricular vagus nerve stimulation may modulate autonomic and inflammatory pathways and may support recovery in patients with acute burn injuries.

This randomized controlled study will be conducted in adults with acute second- or third-degree burn injuries involving 5% to 30% of total body surface area. Eligible participants will be enrolled within the first 72 hours after hospitalization and randomly assigned to an intervention group or a control group.

The intervention group will receive non-invasive auricular vagus nerve stimulation in addition to conventional physiotherapy. Stimulation will be delivered using surface electrodes placed on the auricular region of the ear. Each session will last 20 minutes, and the intervention will be administered for a total of 10 sessions. The control group will receive conventional physiotherapy only. Conventional physiotherapy will be planned according to individual clinical needs and may include strengthening exercises, stretching exercises, proprioceptive neuromuscular facilitation, electrotherapy, balance exercises, fine motor activities, active range of motion exercises, and neurodevelopmental treatment approaches.

Outcome assessments will be performed before treatment and after completion of the 10 treatment sessions. Inflammatory response will be evaluated using C-reactive protein levels obtained from routine blood test records. Functional recovery will be evaluated using the Functional Independence Measure, joint range of motion, and muscle strength assessments.

Inclusion criteria

• Aged 18 to 65 years
• Diagnosed with second- or third-degree burn injury involving 5% to 30% of total body surface area
• Enrolled within the first 72 hours after hospitalization due to burn injury
• Stable vital signs and general clinical condition suitable for the intervention
• Able to read and understand Turkish and communicate adequately
• Provided written informed consent

Exclusion criteria

• Severe burn injury in the head and neck region preventing application of the device to the auricular vagus nerve area
• Chronic pulmonary and/or cardiac disease
• Heart rate below 60 beats per minute
• History of epilepsy, severe psychiatric disease, or neurological disorder
• Presence of a cardiac pacemaker or implantable electronic device
• Autoimmune or chronic systemic inflammatory disease
• Cognitive impairment preventing adherence to the study protocol