Contractures in Nursing Home Residents: What Are They and How Do We Prevent Them?
What are contractures? Contractures develop in people who have been physically inactive over long periods of time. Muscle fibers begin breaking down and stiffness increases in affected joints, which leads to a body part or limb to slowly begin pulling toward the body and stiffen in place. Body parts usually affected are hands, feet, legs and arms. Contractures can develop quite quickly, sometimes in less than one week. Severe contractures can take up to one year to resolve to restore the affected body part to proper working order.
Elderly nursing home residents are especially prone to developing contractures due to frailty, such as brittle bones or weakened muscles, or medical conditions. Often, bedridden residents suffer contractures due to their inability to ambulate to receive adequate exercise.
There are several methods that can be used to help prevent contractures or lessen their severity.
POSITIONING
Positioning is important in nursing home residents. Make sure that your loved one is seated properly in chairs, wheelchairs, and beds. You may need to use pillows or cushions to achieve the proper sitting position.
SPLINTING
Often, nursing home facilities utilize splinting devices, such as special boots, wrist cushions, or pads, to help keep the resident's hands or feet from drawing up. Knee and elbow braces are also available to keep knees and elbows from stiffening, while allowing the resident free range of motion. Occasionally, special boots or splints may be used to help prevent toes and fingers from drawing up.
EXERCISE
The most important weapon in preventing contractures is exercise. Nurses, nurse aides, and physical therapy staff are fully aware of contractures and how to help prevent them. Range of motion exercise is very important and staff must take the time to assist immobile residents. Passive range of motion exercises involve gently rotating the affected joint clockwise and counterclockwise and should be performed at least two to three times per day.
