02158nas a2200205   4500000000100000008004100001100001400042700001200056700001300068700001200081700001100093700001600104700001700120245009600137250001500233300001100248490000700259520164000266020004601906       2012                            d1 aHarvey L.1 aKwah L.1 aEyles J.1 aLing M.1 aBen M.1 aHerbert Rob1 aDiong Joanna00aIncidence and predictors of contracture after spinal cord injury-a prospective cohort study  a2012/03/28  a579-840 v503 a<p>
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 &gt;/=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 &gt;/=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 (R(2)<!--=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.-->
</p>
  a1476-5624 (Electronic)1362-4393 (Linking)