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

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.