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European Journal of Physical and Rehabilitation Medicine 2015 June;51(3):269-79


lingua: Inglese

Prevalence of functioning and disability in older patients with joint contractures: a cross-sectional study

Fischer U. 1, Müller M. 1, 2, Strobl R. 1, 2, Bartoszek G. 3, Meyer G. 3, 4, Grill E. 1, 2

1 Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig‑Maximilians‑Universität München, Munich, Germany; 2 German Center for Vertigo and Balance Disorders (DSGZ), Ludwig‑Maximilians‑Universität München, Munich, Germany; 3 School of Nursing Science, Witten/Herdecke University, Witten, Germany; 4 Institute of Health and Nursing Science, Martin‑Luther‑University Halle‑Wittenberg, Halle, Germany


BACKGROUND: Joint contractures are a common problem for older, frail people, particularly in rehabilitation, nursing home and homecare settings. Joint contractures are underreported and sparsely empirically investigated despite their high prevalence.
AIM: The objective of this study was to examine the prevalence of functional impairments, activity limitations and participation restrictions of patients with joint contractures using the International Classification of Functioning, Disability and Health (ICF) as a framework. We also examined contextual factors as potential mediators for functioning and disability.
DESIGN: Cross-sectional study.
SETTING: Three acute-geriatric hospitals in and around Munich (Germany).
POPULATION: Patients aged 65 and over with confirmed joint contractures requiring rehabilitation care.
METHODS: The patients were asked to answer a questionnaire that comprised 124 categories of the ICF. Patients’ problems in functioning were registered separately for each category. Data were collected through face-to-face interviews with patients and health professionals and from patients’ medical records.
RESULTS: One hundred and fifty patients were eligible and agreed to participate. Mean age was 82.5 years (SD: 7.4), 64.8% of the patients were female. Problems in “muscle power functions” (95.9%) and “driving human-powered transportation” (89,6%) were those most frequently identified. ‘Health services, systems and policies’ (98,6%) was the most frequent environmental facilitator.
CONCLUSION: Aged persons with joint contractures experience high levels of disability. Specifically, mobility, participation restrictions and interactions with the environment emerged as important issues of our study.
CLINICAL REHABILITATION IMPACT: Mobility and support by others were frequently mentioned as aspects relevant for persons with joint contractures. These aspects have to be considered when assessing the impact of joint contractures.

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