title: Impact of joint contracture on older persons in a geriatric setting: A cross-sectional study.
abstract: BACKGROUND
  Joint contractures are a common phenomenon in older persons and are assessed by measuring the range of motion; however, little is known about the impact of joint contractures on activities of daily living (ADL).
  
  
  OBJECTIVE
  The aim of the study was to identify problems related to joint contracture of older persons in a geriatric setting using the international classification of functioning, disability and health (ICF) as a framework.
  
  
  METHODS
  A cross-sectional study was conducted between February and July 2013 in nursing homes (n=11) and geriatric rehabilitation hospitals (n=3) in North Rhine-Westphalia, Germany. The study population included persons aged ≥65 years with at least one diagnosis of joint contracture. If the participant was unable to adequately answer the best informed next of kin or staff nurse acted as a proxy. A questionnaire with 124 ICF categories was completed through face-to-face interviews with the participants.
  
  
  RESULTS
  A total of 149 participants were included in the study. The mean age was 77.6±6.9 years and 69.8% were women. Problems in climbing (94.0%), walking long distances (92.6%) and kneeling (92.6%) were most frequently identified. The most often identified facilitators in environmental factors were health services, systems and policies (93.2%), whereas the leading barrier was climate (30.3%).
  
  
  CONCLUSIONS
  Joint contractures have a huge impact on functioning and social participation and particularly on personal mobility. From the nursing and rehabilitation perspective, assessments should not only measure joint mobility but also determine and quantify the consequences of contractures on ADL.
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Stockumer Str. 12, 58453, Witten, Germany. gabriele.bartoszek@uni-wh.de.|Institute for Health and Nursing Science, Martin-Luther-University Halle-Wittenberg, Halle, Germany. gabriele.bartoszek@uni-wh.de.
authors.forename: G
authors.initials: G
authors.lastname: Bartoszek
authors.affiliation: Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Fischer
authors.affiliation: Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.|German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Grill
authors.affiliation: Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.|German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Müller
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Stockumer Str. 12, 58453, Witten, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Nadolny
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Stockumer Str. 12, 58453, Witten, Germany.|Institute for Health and Nursing Science, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Meyer
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D002980:Climate; D003286:Contracture / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D018434:Sickness Impact Profile
keywords: Activities of daily living; Geriatric nursing; Outcome assessment health care; Questionnaire; Social participation