Incidence and predictors of contracture after spinal cord injurya prospective cohort study

Diong, J; Harvey, LA; Kwah, LK; Eyles, J; Ling, MJ; Ben, M; Herbert, RD

Incidence and predictors of contracture after spinal cord injurya prospective cohort study

Diong, J Harvey, LA Kwah, LK

Eyles, J Ling, MJ Ben, M Herbert, RD

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Publication Type:: Journal Article
Citation:: Spinal Cord, 2012, 50 (8), pp. 579 - 584
Issue Date:: 2012-08-01

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Field	Value	Language
dc.contributor.author	Diong, J	en_US
dc.contributor.author	Harvey, LA	en_US
dc.contributor.author	Kwah, LK https://orcid.org/0000-0002-9809-9859	en_US
dc.contributor.author	Eyles, J	en_US
dc.contributor.author	Ling, MJ	en_US
dc.contributor.author	Ben, M	en_US
dc.contributor.author	Herbert, RD	en_US
dc.date.issued	2012-08-01	en_US
dc.identifier.citation	Spinal Cord, 2012, 50 (8), pp. 579 - 584	en_US
dc.identifier.issn	1362-4393	en_US
dc.identifier.uri	http://hdl.handle.net/10453/43220
dc.description.abstract	Study design:Prospective cohort study.Objectives:To determine incidence of contracture and develop prediction models to identify patients susceptible to contracture after spinal cord injury.Setting:Two Sydney spinal cord injury units.Methods:A total of 92 consecutive patients with acute spinal cord injury were assessed within 35 days of injury and 1 year later. Incidence of contracture at 1 year was measured in all major appendicular joints by categorizing range of motion on a 4-point scale (0-no contracture to 3-severe contracture), and in the wrist, elbow, hip and ankle by measuring range of motion at standardized torque. Multivariate models were developed to predict contracture at ≥1 year using age, neurological status, spasticity, pain and limb fracture recorded at the time of injury.Results:At 1 year, 66% of participants developed at least one contracture (defined as 1 point deterioration on the 4-point scale). Incidence of contracture at each joint was: shoulder 43%, elbow and forearm 33%, wrist and hand 41%, hip 32%, knee 11% and ankle 40%. Incidence of contracture determined by standardized torque measures of range (defined as loss of ≥10 degrees) was: elbow 27%, wrist 26%, hip 23% and ankle 25%. Prediction models were statistically significant but lacked sufficient predictive accuracy to be clinically useful (R2 ≤ 31%).Conclusion:The incidence of contracture in major joints 1 year after spinal cord injury ranges from 11-43%. The ankle, wrist and shoulder are most commonly affected. It is difficult to accurately predict those susceptible to contracture soon after injury. © 2012 International Spinal Cord Society All rights reserved.	en_US
dc.relation.ispartof	Spinal Cord	en_US
dc.relation.isbasedon	10.1038/sc.2012.25	en_US
dc.subject.classification	Rehabilitation	en_US
dc.subject.mesh	Joints	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Contracture	en_US
dc.subject.mesh	Muscle Spasticity	en_US
dc.subject.mesh	Spinal Cord Injuries	en_US
dc.subject.mesh	Range of Motion, Articular	en_US
dc.subject.mesh	Severity of Illness Index	en_US
dc.subject.mesh	Incidence	en_US
dc.subject.mesh	Cohort Studies	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Predictive Value of Tests	en_US
dc.subject.mesh	Torque	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.title	Incidence and predictors of contracture after spinal cord injurya prospective cohort study	en_US
dc.type	Journal Article
utslib.citation.volume	8	en_US
utslib.citation.volume	50	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1109 Neurosciences	en_US
utslib.for	1106 Human Movement and Sports Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	8	en_US
pubs.publication-status	Published	en_US
pubs.volume	50	en_US

Abstract:

Study design:Prospective cohort study.Objectives:To determine incidence of contracture and develop prediction models to identify patients susceptible to contracture after spinal cord injury.Setting:Two Sydney spinal cord injury units.Methods:A total of 92 consecutive patients with acute spinal cord injury were assessed within 35 days of injury and 1 year later. Incidence of contracture at 1 year was measured in all major appendicular joints by categorizing range of motion on a 4-point scale (0-no contracture to 3-severe contracture), and in the wrist, elbow, hip and ankle by measuring range of motion at standardized torque. Multivariate models were developed to predict contracture at ≥1 year using age, neurological status, spasticity, pain and limb fracture recorded at the time of injury.Results:At 1 year, 66% of participants developed at least one contracture (defined as 1 point deterioration on the 4-point scale). Incidence of contracture at each joint was: shoulder 43%, elbow and forearm 33%, wrist and hand 41%, hip 32%, knee 11% and ankle 40%. Incidence of contracture determined by standardized torque measures of range (defined as loss of ≥10 degrees) was: elbow 27%, wrist 26%, hip 23% and ankle 25%. Prediction models were statistically significant but lacked sufficient predictive accuracy to be clinically useful (R2 ≤ 31%).Conclusion:The incidence of contracture in major joints 1 year after spinal cord injury ranges from 11-43%. The ankle, wrist and shoulder are most commonly affected. It is difficult to accurately predict those susceptible to contracture soon after injury. © 2012 International Spinal Cord Society All rights reserved.

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http://hdl.handle.net/10453/43220