title: Acquired deforming hypertonia and contractures in elderly subjects: definition and prevalence in geriatric institutions (ADH survey).
abstract: OBJECTIVE
  By proposing a new terminology (acquired deforming hypertonia or ADH) and a new definition for contractures, the main objective of this study was to establish their prevalence among institutionalized elderly patients. Secondary objectives were to analyze the negative impact of ADH and collect the opinions of clinicians on the possible treatments available.
  
  
  METHODS
  A multicenter cross-sectional study was conducted among residents of 39 geriatric institutions (29 EHPAD and 10 USLD). All subjects presenting at least one ADH were surveyed over a one-week period.
  
  
  RESULTS
  Among 3145 observed patients (mean age 88.9±9.7 years) 22% (n=692) presented at least one ADH. In average, each patient presented 4.4±3.2 ADHs. Negative consequences on self-care, nursing and difficulties in getting dressed were most frequently observed. Only 25.4% of clinicians considered the ADH to be potentially reversible. Physical therapy was the therapeutic option most frequently chosen over medication and surgery.
  
  
  CONCLUSIONS
  This study confirms the important prevalence of ADH among elderly institutionalized patients. Consequences on the level of dependence were significant. It seems relevant to elaborate hierarchical therapeutic strategies in order to counter these disorders and the fatalism that ensues.
authors: Service de MPR, Pôle neurosciences cliniques, groupe Pellegrin & EA 4136, université Bordeaux Segalen, CHU de Bordeaux, 33076 Bordeaux Cedex, France. Electronic address: patrick.dehail@chu-bordeaux.fr.
authors: P
authors: P
authors: Dehail
authors: Service de MPR, groupe HUPNVS, hôpital Bichat - Claude-Bernard, AP-HP, 75018 Paris, France.
authors: O
authors: O
authors: Simon
authors: Soins de suite et de réadaptation gériatrique, centre Antonin-Balmes - Bellevue, 34295 Montpellier Cedex 5, France.
authors: A L
authors: AL
authors: Godard
authors: Service de gériatrie, groupe HUPNVS, hôpital Bichat - Claude-Bernard, AP-HP, 75018 Paris, France.
authors: N
authors: N
authors: Faucher
authors: Fédération de rééducation neurolocomotrice, groupe hospitalier Henri-Mondor, AP-HP, 94000 Créteil, France.
authors: Y
authors: Y
authors: Coulomb
authors: Service de MPR, hôpital Raymond-Poincaré, AP-HP, 92380 Garches, France.
authors: A
authors: A
authors: Schnitzler
authors: Unité de neuro-orthopédie, hôpital Raymond-Poincaré, AP-HP, 92380 Garches, France; Groupe Korian, 32, rue Guersant, 75017 Paris, France.
authors: P
authors: P
authors: Denormandie
authors: Département de gériatrie, université Montpellier 1, CHU de Montpellier, 34967 Montpellier Cedex 2, France.
authors: C
authors: C
authors: Jeandel
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003286:Contracture / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009122:Muscle Hypertonia / Q000453:epidemiology*; D009735:Nursing Homes; D015995:Prevalence; D012648:Self Care; D009626:Terminology as Topic
keywords: Contractures; Hypertonia; Hypertonie; Institutionalized elderly patients; Prevalence; Prévalence; Rétractions tendineuses; Sujets âgés institutionnalisés