To observe the application effect of rehabilitation therapy combined with strong muscle activation training in patients with hand burn plastic surgery. Methods A total of 100 patients with hand burn plastic surgery who were treated in our hospital from January 2021 to January 2022 were randomly divided into control group and observation group, with 50 cases in each group. The control group was given sequential pressure rehabilitation therapy, and the observation group was combined with strong muscle activation training on the basis of the control group. The hand function, quality of life and intervention satisfaction were compared between the two groups. Results The Carroll score of the two groups after intervention was higher than that before intervention, and the Carroll score of the observation group was higher than that of the control group, the difference was statistically significant (P <0.05). The daily living ability of the observation group was better than that of the control group, and the difference was statistically significant (P <0.05). The satisfaction of the observation group was 92.00%, which was higher than 86.00% of the control group, and the difference was statistically significant (P <0.05). Conclusion Rehabilitation therapy combined with strong muscle activation training can promote the recovery of hand function in patients with hand burn plastic surgery, improve their daily living ability, and patients have higher satisfaction with rehabilitation.