Kerjean Nicolas, Banydeen Rishika, Glize Bertrand, Bonnet Michel, Rene-Corail Patrick, Tabue Teguo Maturín, Dramé Moustapha, Dehail Patrick, Barnay Jose-Luis
Centre Hospitalier Universitaire de Martinique, 97200 Fort-De-France, France.
Service de Médecine Physique et Réadaptation, Pôle de Neurosciences Cliniques, CHU de Bordeaux, 33000 Bordeaux, France.
J Clin Med. 2025 Feb 12;14(4):1192. doi: 10.3390/jcm14041192.
Osteoarticular deformities or contractures in institutionalized elderly individuals, described as acquired deforming hypertonia (ADH), have a multifactorial origin. The reported prevalence of ADH in French Caucasian patients in long-term care units (LTCUs) is 25.6%. To date, ADH in the Caribbean population has never been studied. We aimed to assess the prevalence and characteristics of ADH in such a population. This was a cross-sectional observational study of a French Caribbean population in Martinique in which patients aged 75 years or older were institutionalized in LTCUs during the study period. Data extraction from the medical files of eligible LTCU patients was conducted to assess the prevalence, clinical characteristics, and impact of ADH on patients' daily care. The assessments were performed collaboratively between the patients' geriatric team and a PM&R physician. In total, 81 patients were included, with an ADH prevalence of 77.8%. Reported ADH was bilateral (86%) or multiple (66% of patients had ≥5 ADH) and was responsible for major alterations in terms of hygiene, dressing, pain, and skin damage. ADH patients had a high level of dependence (GMP = 924), and this level of dependence was significantly associated with the presence of at least one ADH ( < 0.001) regardless of prior disease. The incidence of ADH in our Caribbean population seems twice as high as that in Caucasian patients, underlining the necessity for this nosological framework to be better recognized, particularly in an insular context. Local campaigns for the prevention and recognition of ADH must be considered, and targeted multidisciplinary protocols need to be established for adapted care in all institutions receiving elderly people.
在机构养老的老年人中出现的骨关节畸形或挛缩,被称为获得性变形性张力亢进(ADH),其病因是多因素的。据报道,法国白种人长期护理机构(LTCU)患者中ADH的患病率为25.6%。迄今为止,加勒比地区人群中的ADH从未被研究过。我们旨在评估该人群中ADH的患病率和特征。这是一项对马提尼克岛法国加勒比人群的横断面观察性研究,研究期间75岁及以上的患者被安置在LTCU中。从符合条件的LTCU患者的病历中提取数据,以评估ADH的患病率、临床特征及其对患者日常护理的影响。评估由患者的老年医学团队和一名物理医学与康复医师共同进行。总共纳入了81名患者,ADH患病率为77.8%。报告的ADH为双侧(86%)或多发(66%的患者有≥5处ADH),并导致了在卫生、穿衣、疼痛和皮肤损伤方面的重大改变。ADH患者的依赖程度很高(GMP = 924),无论先前疾病如何,这种依赖程度与至少一处ADH的存在显著相关(< 0.001)。我们加勒比人群中ADH的发病率似乎是白种人患者的两倍,这凸显了更好地认识这一疾病分类框架的必要性,特别是在岛屿环境中。必须考虑开展当地的ADH预防和识别运动,并为所有接收老年人的机构制定有针对性的多学科方案,以提供适应性护理。