Contracture
What is a contracture?
A contracture is an abnormal, forced, position of a joint or part of the body. Contractures arise when parts of the body are set in a certain position for a long time without any activity. This results in a permanent shortening or contraction of the muscle, leading to a distortion or stiffening of that part of the body.
What are the complaints associated with a contracture?
A contracture results in restricted movement, pain and malposition.
People with intellectual disabilities sometimes find it impossible to communicate pain. The people around them may then notice only a change in behaviour and the malposition.
How common are contractures in the general population?
No general information is available in the literature. However, there have been studies of subgroups. Contractures have been found in 15 to 75% of older people (especially elderly people in nursing homes).
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Contractures are seen in 75% of people with Alzheimer's disease, in 16 to 84% of people with brain injury/stroke, and in 14 to 51% of people with spinal cord injuries.
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A Dutch study of nursing home residents with disorders of the central nervous system found that 58% had contractures.
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How common are contractures in people with intellectual disabilities?
A recent Australian questionnaire survey of 2540 people with intellectual disabilities (in which questionnaires were answered by carers and parents) found that 26% of the study sample had contractures.
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It can be expected that contractures are equally likely, or more likely, in older people than in the general population. In addition, contractures are very common indeed in people with cerebral palsy owing to the spasticity, the accumulation of connective tissue and reduced muscle strength.
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A study of 26 children with cerebral palsy found collagen accumulation (fibrosis/connective tissue formation) in the spastic muscles of all the children, with the extent of accumulation being linked to the severity of spasticity.
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A Dutch research found restricted joint movement in 60% of 119 children with spasticity.
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565Meijer R, Wolswijk A, Eijsden HV. Prevalence, impact and treatment of spasticity in nursing home patients with central nervous system disorders: a cross-sectional study. Disabil Rehabil. 2016 Mar 3:1-9.
Meijer R, Wolswijk A, Eijsden HV. Prevalence, impact and treatment of spasticity in nursing home patients with central nervous system disorders: a cross-sectional study. Disabil Rehabil. 2016 Mar 3:1-9.
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315Koritsas S, Iacono T. Secondary conditions in people with developmental disability. Am J Intellect Dev Disabil. 2011 Jan;116(1):36-47
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313Booth CM, Cortina-Borja MJ, Theologis TN. Collagen accumulation in muscles of children with cerebral palsy and correlation with severity of spasticity. Dev Med Child Neurol. 2001 May;43(5):314-20.
Booth CM, Cortina-Borja MJ, Theologis TN. Collagen accumulation in muscles of children with cerebral palsy and correlation with severity of spasticity. Dev Med Child Neurol. 2001 May;43(5):314-20.
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314Wichers M, Hilberink S, Roebroeck ME, van Nieuwenhuizen O, Stam HJ. Motor impairments and activity limitations in children with spastic cerebral palsy: a Dutch population-based study. J Rehabil Med. 2009 Apr;41(5):367-74.
Wichers M, Hilberink S, Roebroeck ME, van Nieuwenhuizen O, Stam HJ. Motor impairments and activity limitations in children with spastic cerebral palsy: a Dutch population-based study. J Rehabil Med. 2009 Apr;41(5):367-74.