The epidemiology of major joint contractures: a systematic review of the literature.

Clinical Epidemiology Program, Ottawa Health Research Institute, Ontario, Canada.
Clinical Orthopaedics and Related Research (Impact Factor: 2.88). 04/2007; 456:22-9. DOI: 10.1097/BLO.0b013e3180308456
Source: PubMed

ABSTRACT Current knowledge on the epidemiology of major joint contractures is limited. We systematically reviewed the literature to identify studies examining the epidemiology of joint contracture regardless of clinical condition. Epidemiologic measures of interest were prevalence, incidence, and prognostic risk factors. We used Medline to identify all epidemiologic studies of major joint contractures published from 1966 to March 2005. There was a high prevalence of major joint contractures. Most studies focused on one joint rather than including all relevant major contractures. However, most studies did provide a definition of a contracture or the measures used to assess contractures. Immobility is a highly prevalent disability in at-risk populations, and constitutes a tremendous burden to patients in nursing homes, hospitals, and the outpatient community. The lack of epidemiologic data is a major impediment to providing appropriate treatment.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Joint contractures are a common phenomenon in older persons and are assessed by measuring the range of motion; however, little is known about the impact of joint contractures on activities of daily living (ADL). The aim of the study was to identify problems related to joint contracture of older persons in a geriatric setting using the international classification of functioning, disability and health (ICF) as a framework. A cross-sectional study was conducted between February and July 2013 in nursing homes (n = 11) and geriatric rehabilitation hospitals (n = 3) in North Rhine-Westphalia, Germany. The study population included persons aged ≥ 65 years with at least one diagnosis of joint contracture. If the participant was unable to adequately answer the best informed next of kin or staff nurse acted as a proxy. A questionnaire with 124 ICF categories was completed through face-to-face interviews with the participants. A total of 149 participants were included in the study. The mean age was 77.6±6.9 years and 69.8 % were women. Problems in climbing (94.0 %), walking long distances (92.6 %) and kneeling (92.6 %) were most frequently identified. The most often identified facilitators in environmental factors were health services, systems and policies (93.2 %), whereas the leading barrier was climate (30.3 %). Joint contractures have a huge impact on functioning and social participation and particularly on personal mobility. From the nursing and rehabilitation perspective, assessments should not only measure joint mobility but also determine and quantify the consequences of contractures on ADL.
    Zeitschrift für Gerontologie + Geriatrie 05/2015; DOI:10.1007/s00391-015-0895-y · 1.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Joint contractures are characterized as impairment of the physiological movement of joints due to deformity, disuse or pain and have major impact especially for older individuals in geriatric care. Some measures for the assessment of the impact of joint contractures exist. However, there is no consensus on which aspects should constantly be measured. Our objective was to develop a standard-set based on the ICF for describing functioning and disability in older individuals with joint contractures in geriatric care settings, giving special emphasis to activities and participation. The ICF-based standard set was developed in a formal decision-making and consensus process and based on an adapted version of the protocol to develop ICF Core Sets. These are sets of categories from the ICF, serving as standards for the assessment, communication and reporting of functioning and health for clinical studies, clinical encounters and multi-professional comprehensive assessment and management. Twenty-three experts from Germany and Switzerland selected 105 categories of the ICF component Activities and Participation for the ICF-based standard set. The largest number of categories was selected from the chapter Mobility (50 categories, 47.6%). The standard set for older individuals with joint contractures provides health professionals with a standard for describing patients' activity limitations and participation restrictions. The standard set also provides a common basis for the development of patient-centered measures and intervention programs. The preliminary version of the ICF-based standard set will be tested in subsequent studies with regard to its psychometric properties. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Archives of gerontology and geriatrics 03/2015; DOI:10.1016/j.archger.2015.03.005 · 1.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the present study was to investigate the gait and muscle strength characteristics in total knee arthroplasty (TKA) patients with patellofemoral pain syndrome (PFPS) before and six months after surgery. Eight patients (4 men and 4 women) aged 58–77 years with PFPS following unilateral TKA who had primary degenerative knee OA participated in the study before and six months after reoperation. In patients was registered the active range of motion (AROM) of knee extension and flexion, hip abduction and adduction. Isometric maximal voluntary contraction (IMVC) force of knee flexors, extensors, abductors and adductors was measured and gait kinematic characteristics and kinetic characteristics of knee joint were recorded. Knee flexion AROM in the involved leg was significantly lower (p<0.05) as compared to the uninvolved leg pre- and post-surgery. The patients had greater (p<0.05) hip abduction AROM and significant increase (31%, p<0.05) of IMVC force of the involved legʼs hip abductors postoperatively as compared before surgery. Six months after surgery 38 H. Gapeyeva et al. a significant (p<0.05) improvement of gait spatiotemporal characteristics (increase of swing time and stride length (p<0.05), together with decrease of stance time and cadence, as well increase of stride length) was noted in the involved leg. In TKA patients 6 months after reoperation due to PFPS the knee joint function in involved leg was significantly improved and the positive changes in gait with comfortable velocity took place as compared before surgery.
    11/2011; 17:37-52. DOI:10.12697/akut.2011.17.03