Contractures with special reference in elderly: definitions and risk factors - A systematic review with practical implications

By: Offenbacher M, Sauer S, Muller M, Grill E, Daubner A, Randzio O, Niko Kohls, Herold-Majumdar A
Publication Name: Disability and Rehabilitation
Year: 2013

Purpose: Contractures are common problems for the elderly with far reaching functional and
medical consequences. The aim of this systematic literature review was to give an overview of
contracture and to identify potential risk factors associated with contractures. Methods: A
systematic literature search with two objectives limited to the last 10 years was performed to
identify studies dealing with definition of contracture (objective 1¼O1) and with risk factors
(objective 2¼O2). Predefined information including age, sample size, study design, setting,
condition, joint, definition of contracture, mode of measurement, and whether inter- and/or
intra-rater reliability were assessed, as well as risk factors of contracture were extracted. Results:
One hundred and sixty one and 25 studies were retrieved. After applying exclusion criteria 47
studies (O1) and 3 studies (O2) remained. Only 9 studies (O1) provided a definition of
contracture. In 3 studies (O2) several potential risk factors were identified. Conclusions: In most
of the studies it seems that the presence of a contracture is equivalent with the presence of
restriction in the range of motion (ROM) of a joint. Very little is known about risk factors for
contractures. But it seems that immobility may play a pivotal role in the development of this

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