Joint contractures in the intensive care unit: quality of life and function 3.3 years after hospital discharge

Clavet, Heidi; Doucette, Steve; Trudel, Guy

doi:10.3109/09638288.2014.913707

Cited by 32 publications

(29 citation statements)

References 29 publications

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“…In the third group of patients, contractures result when mobility is reduced, such as the case in bedridden patients in intensive care units (ICUs) and institutionalized elderly people [ 5 , 19 , 30 , 31 ]. A more than one-third incidence of developing a joint contracture in a large joint was documented for ICU patients with a hospital stay longer than 2 weeks [ 32 ]. A follow up of 155 patients who developed joint contractures while in the ICU revealed higher mortality 3.3 years after discharge [ 32 ].…”

Section: Etiology Of Joint Contracturesmentioning

confidence: 99%

“…A more than one-third incidence of developing a joint contracture in a large joint was documented for ICU patients with a hospital stay longer than 2 weeks [ 32 ]. A follow up of 155 patients who developed joint contractures while in the ICU revealed higher mortality 3.3 years after discharge [ 32 ]. Joint contractures are prevalent in institutionalized elderly people with chronic disease and 75% had knee flexion contractures that significantly limited ambulation [ 31 ].…”

Section: Etiology Of Joint Contracturesmentioning

confidence: 99%

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Noninflammatory Joint Contractures Arising from Immobility: Animal Models to Future Treatments

Wong

Trudel

Laneuville

2015

BioMed Research International

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Joint contractures, defined as the limitation in the passive range of motion of a mobile joint, can be classified as noninflammatory diseases of the musculoskeletal system. The pathophysiology is not well understood; limited information is available on causal factors, progression, the pathophysiology involved, and prediction of response to treatment. The clinical heterogeneity of joint contractures combined with the heterogeneous contribution of joint connective tissues to joint mobility presents challenges to the study of joint contractures. Furthermore, contractures are often a symptom of a wide variety of heterogeneous disorders that are in many cases multifactorial. Extended immobility has been identified as a causal factor and evidence is provided from both experimental and epidemiology studies. Of interest is the involvement of the joint capsule in the pathophysiology of joint contractures and lack of response to remobilization. While molecular pathways involved in the development of joint contractures are being investigated, current treatments focus on physiotherapy, which is ineffective on irreversible contractures. Future treatments may include early diagnosis and prevention.

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Section: Etiology Of Joint Contracturesmentioning

confidence: 99%

Section: Etiology Of Joint Contracturesmentioning

confidence: 99%

Noninflammatory Joint Contractures Arising from Immobility: Animal Models to Future Treatments

Wong

Trudel

Laneuville

2015

BioMed Research International

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“…Secondly, it describes quality-of-life related to the survivor's health status. Lastly, areas not covered by PICS or SF-36/EQ-5D such as dysphagia 28 , joint contractions 29 , sleep disturbances 30 and personal nances 31 are included, all previously described problems after intensive care.…”

Section: Discussionmentioning

confidence: 99%

Long-term Health-related Quality of Life and Burden of Disease After Intensive Care: Development of a Patient-reported Outcome Measure.

Malmgren

Waldenström

Rylander

et al. 2020

Preprint

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BackgroundICU survivorship includes a diverse burden of disease. To understand the extent of the problems, the right issues must be identified, and the right questions need to be asked to the patients. Current follow-up instruments lack detailed questions in several areas relevant to survivors. Our aim was to identify health-related problems relevant and unique to ICU survivors, and to construct a comprehensive questionnaire able to address these issues.Methods Thirty-three ICU survivors were interviewed at least six months after ICU discharge. All types of everyday dysfunctions and disabilities were extracted and compiled into a questionnaire. The questionnaire was tested on ICU survivors and non-ICU treated subjects. Inclusion criteria for the ICU survivors were an ICU stay of at least 72 hours with the ICU discharge six months to three years prior to the study. The non-ICU treated subjects were obtained from the Swedish Population Register, matched for age and sex. Eligible participants received an invitation letter and were contacted by phone. If willing to participate, they were sent the questionnaire. ResultsAnalysis of the interviews yielded 238 questions in 13 domains: cognition, fatigue, physical health, pain, psychological health, activities of daily life, sleep, appetite and alcohol, sexual health, sensory functions, gastrointestinal, urinary tract and work life.In total, 395 of 518 ICU survivors and 197 of 231 non-ICU treated subjects returned a completed questionnaire, the response rate being 76.2% and 85.3% respectively. The two groups differed significantly in 16 of 25 comorbidities. ICU survivors differed in a majority of questions (p ≤ 0.05) compared to non-ICU treated subjects, distributed over all 13 domains. ConclusionsThis study describes the first step in developing a designated questionnaire for identification of health-related quality of life issues and long-term burden of disease after intensive care. A first version of the questionnaire was answered by 395 ICU survivors. The questionnaire could identify that they experience severe difficulties in a wide range of domains compared to non-ICU treated subjects.Trial registrationClinicalTrials.gov Ref# NCT 02767180

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“…Joint contractures in the ICU are associated with higher mortality and can impose irreversible disability; patients who spend 2 or more weeks in an ICU and develop joint contractures identify more difficulty with mobility 3 or more years after discharge. 29 Furthermore, limitations in volitional oral intake may ensue in patients with significant upper-extremity joint contractures. Occupational and physical therapists assist with identifying strategies and devices to treat and prevent joint contractures in the ICU to prevent long-term functional limitations.…”

Section: Rommentioning

confidence: 99%

Overview of Intensive Care Unit‐Related Physical and Functional Impairments and Rehabilitation‐Related Devices

et al. 2018

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Rehabilitation after critical illness requires a multidisciplinary effort. Nutrition support of critically ill patients aims to correct the imbalance between protein synthesis and protein degradation to maximize strengthening and muscle mass, whereas physical and occupational therapists focus on optimizing strength and mobility through functional activity to help intensive care (ICU) patients return to their precritical illness level of function and improve quality of life. Early mobility has become the new standard of care for ICU patients. Therapists utilize various devices and technologies to increase the feasibility of early mobility and enhance the rehabilitation process to ensure that patients reach their rehabilitation goals. Tools such as electrical stimulation, cycle ergometers, dynamic tilt tables, and resistive bands aid in strengthening. Therapists use safe patient-handling equipment and ambulation aids to address gait impairments. Adaptive toileting, dressing, bathing, and feeding tools facilitate greater independence with activities of daily living. Augmentative and alternative communication devices promote well-being and communication of basic needs. Splints prevent joint contracture and maintain functional range of motion. Overall, many rehabilitation devices are safe and feasible for use in an ICU setting and serve to maximize strength and functional independence. The purpose of this narrative review is to discuss the benefits and limitations of available rehabilitation devices in the context of critical illness rehabilitation goals.

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Joint contractures in the intensive care unit: quality of life and function 3.3 years after hospital discharge

Cited by 32 publications

References 29 publications

Noninflammatory Joint Contractures Arising from Immobility: Animal Models to Future Treatments

Noninflammatory Joint Contractures Arising from Immobility: Animal Models to Future Treatments

Long-term Health-related Quality of Life and Burden of Disease After Intensive Care: Development of a Patient-reported Outcome Measure.

Overview of Intensive Care Unit‐Related Physical and Functional Impairments and Rehabilitation‐Related Devices

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