Impact of joint contracture on older persons in a geriatric setting

Bartoszek, Gabriele; Fischer, Uli; Grill, Eva; Müller, Martin; Nadolny, Stephan; Meyer, Gabriele

doi:10.1007/s00391-015-0895-y

Cited by 20 publications

(13 citation statements)

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“…We had previously conducted standardized [ 10 , 11 ] and qualitative interviews [ 18 ] with nursing home residents and patients in geriatric rehabilitation hospitals. Our purpose was to assess and describe the prevalence of activity limitations and participation restrictions of older persons with joint contractures, and the impact of joint contractures on functioning and social participation from the patients’ perspective.…”

Section: Methodsmentioning

confidence: 99%

“…To investigate potential intervention goals, we analysed data from our previous cross-sectional study by means of graphical modelling [ 10 , 11 ] Graphical modelling is an approach to visualize conditional dependencies between various variables where most relevant dependencies are displayed in a netlike structure by drawing a graph. The associations within graphical models are estimated using generalized linear regression analysis [ 19 – 21 ].…”

Section: Methodsmentioning

confidence: 99%

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Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study

et al. 2018

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BackgroundJoint contractures in nursing home residents limit the capacity to perform daily activities and restrict social participation. The purpose of this study was to develop a complex intervention to improve participation in nursing home residents with joint contractures.MethodsThe development followed the UK Medical Research Council framework using a mixed-methods design with re-analysis of existing interview data using a graphic modelling approach, group discussions with nursing home residents, systematic review of intervention studies, structured 2-day workshop with experts in geriatric, nursing, and rehabilitation, and group discussion with professionals in nursing homes.ResultsGraphic modelling identified restrictions in the use of transportation, walking within buildings, memory functions, and using the hands and arms as the central target points for the intervention. Seven group discussions with 33 residents revealed various aspects related to functioning and disability according the International Classification of Functioning, Disability and Health domains body functions, body structures, activities and participation, environmental factors, and personal factors. The systematic review included 17 studies with 992 participants: 16 randomised controlled trials and one controlled trial. The findings could not demonstrate any evidence in favour of an intervention. The structured 2-day expert workshop resulted in a variety of potential intervention components and implementation strategies. The group discussion with the professionals in nursing homes verified the feasibility of the components and the overall concept. The resulting intervention, Participation Enabling CAre in Nursing (PECAN), will be implemented during a 1-day workshop for nurses, a mentoring approach, and supportive material. The intervention addresses nurses and other staff, residents, their informal caregivers, therapists, and general practitioners.ConclusionsIn view of the absence of any robust evidence, the decision to use mixed methods and to closely involve both health professionals and residents proved to be an appropriate means to develop a complex intervention to improve participation of and quality of life in nursing home residents. We will now evaluate the PECAN intervention for its impact and feasibility in a pilot study in preparation for an evaluation of its effectiveness in a definitive trial.Trial registrationGerman clinical trials register, reference number DRKS00010037 (12 February 2016).

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study

et al. 2018

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“…Elderly individuals may experience substantial constraints in mobility and thus may experience activity and participation restrictions. Upper limb contractures may hinder independent eating, whereas lower limb contractures may restrict ambulation [ 21 – 24 ]. These limitations to activity may adversely affect the QoL of elderly residents in LTCFs [ 7 , 25 , 26 ] and result in disability among elderly residents and an increase in social expenditure [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Associations among quality of life, activities, and participation in elderly residents with joint contractures in long-term care facilities: a cross-sectional study

et al. 2022

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Background Joint contractures and degenerative osteoarthritis are the most common joint diseases in the elderly population, can lead to limited mobility in elderly individuals, can exacerbate symptoms such as pain, stiffness, and disability, and can interfere with social participation and quality of life, thus affecting mental health. However, relevant studies on this topic are very limited. This study describes the associations of joint contracture categories and sites in elderly residents in long-term care facilities with their quality of life, activities, and participation. Methods Elderly individuals with joint contractures who were residents in long-term care facilities were recruited. The World Health Organization (WHO) Quality of Life and the WHO Disability Assessment Schedule 2.0 were used to survey the participants. Correlations, multiple linear regressions, and multiple analyses of variance, with joint contractures as the response variable, were used in the statistical analysis. Results The final statistical analysis included 232 participants. The explanatory power of contracture sites on activities and participation had a moderate strength of association (η2 = .113). Compared with elderly residents with joint contractures and osteoarthritis isolated to the upper limbs, those with joint contractures and osteoarthritis in both the upper and lower limbs had significantly worse activity and participation limitations. No significant differences in activity and participation were found between elderly residents with joint contractures affecting only the upper limbs and those with joint contractures affecting only the lower limbs (F1,226 = 2.604 and F1,226 = 0.674, nonsignificant). Osteoarthritis had the greatest impact on activity limitations and participation restrictions among elderly residents with joint contractures affecting both the upper and lower limbs (F1,226 = 6.251, p = .014). Conclusions Elderly residents in long-term care facilities belonging to minority groups, with a history of stroke, and with osteoarthritis are at a high risk of developing activity limitations and participation restrictions. Moreover, compared with other contraction sites, regardless of osteoarthritis, joint contractures affecting both the upper and lower limbs were associated with the greatest activity limitations and participation restrictions. Trial registration This study has been registered in the Chinese Clinical Trial Registry, registration number and date:ChiCTR2000039889 (13/11/2020).

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“…Joint contractures resulted in limited and restricted joint ROM [1,17], which exacerbates OA-related symptoms, such as immobility, pain, stiffness, and disability, and accelerates OA progression [18]. Elderly individuals may experience substantial constraints in mobility and thus may experience activity and participation restrictions, such as standing, walking, or socializing limitations [19][20][21], which, in turn, may affect the QoL of elderly residents in long-term care facilities [8,22,23] and result in the disability of elderly residents and an increase in social expenditure [24]. In particular, elderly residents with joint contractures and OA have a higher chance of developing the abovementioned conditions than do elderly residents with OA only [18].…”

Section: Introductionmentioning

confidence: 99%

Relation of Quality of Life, Activities and Participation with Contracture Categories, and Contracture Sites in Elderly Residents With Joint Contractures in Long-Term Care Facilities

Chen

Lin

Yeh

et al. 2021

Preprint

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Background: Joint contractures and degenerative osteoarthritis are the most common joint diseases in the elderly, can lead to limited mobility in the elderly with diseases, can exacerbate symptoms, such as pain, stiffness and disability, and can interfere with social participation and quality of life, affecting mental health. However, relevant studies on this topic are very limited. The purpose of this study is to investigate the relationship of demographic characteristics and joint contracture categories and sites with the quality of life, activity limitations, and participation restrictions of elderly residents in long-term care facilities.Methods: A cross-sectional observational study. Elderly individuals with joint contractures who were residents in long-term care facilities were recruited. The World Health Organization (WHO) Quality of Life and the WHO Disability Assessment Schedule 2.0 were used to survey the participants. Correlations, multiple linear regressions, and multiple analyses of variance, with joint contractures as the response variable, were used in the statistical analysis.Results: The final statistical analysis included 232 participants. The explanatory power of contracture sites on activities and participation had a moderate strength of association (η2 = .113). Compared with elderly residents with joint contractures and osteoarthritis in isolated upper limbs, elderly residents with joint contractures and osteoarthritis in both the upper and lower limbs had significantly worse activity and participation limitations. There were no significant differences in activity and participation between elderly residents with joint contractures affecting isolated upper limbs and elderly residents with joint contractures affecting isolated lower limbs (F1,226 = 2.604 and F1,226 =.674, n.s.). Osteoarthritis had the greatest impact on activity limitations and participation restrictions of elderly residents with joint contractures affecting both upper and lower limbs (F1,226 = 6.251, p = .014).Conclusions: Elderly residents in long-term care facilities who are minorities and have non-mainstream religious beliefs, history of stroke and osteoarthritis are at high risk of developing activity limitations and participation restrictions. Moreover, compared with other contractile sites, regardless of osteoarthritis, elderly residents with joint contractures affecting both upper and lower limbs had the most substantial activity limitations and participation restrictions.Trial registration: This study has been registered in the Chinese Clinical Trial Registry, Registration number and date: ChiCTR2000039889

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Impact of joint contracture on older persons in a geriatric setting

Abstract: 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.

Cited by 20 publications

References 29 publications

Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study

Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study

Associations among quality of life, activities, and participation in elderly residents with joint contractures in long-term care facilities: a cross-sectional study

Relation of Quality of Life, Activities and Participation with Contracture Categories, and Contracture Sites in Elderly Residents With Joint Contractures in Long-Term Care Facilities

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