Ways to Prevent Contractures
The nursing home staff can help to prevent or slow down contractures in the following ways:- Positioning. Staff members should ensure that residents are correctly positioned in their beds, chairs, or wheelchairs. This can be accomplished by doing what is necessary to modify beds and chairs—for example, by adding extra cushions, head rests, or chair trays.
- Splinting. Splinting devices such as specially designed boots, wrist cushions, and pads may prevent contractures in the hands and feet. Lightweight, padded orthopedic supports can prevent and treat contractures that result from immobility. Hinged elbow and knee braces allow residents to move their limbs while preventing the muscles from contracting.
- Exercise. Range-of-motion exercises may prevent or reduce the severity of contractures. Both passive and active range-of-motion exercises should be performed on a regular basis. Residents who are unable to move their own limbs may need staff members to gently exercise the limbs.
Ways to Treat Contractures
Contractures in elderly people are usually treated in a conservative fashion, but occasionally, surgery may be necessary. Once a resident has contractures, staff can keep the condition from worsening by using the following treatments:- Electrical stimulation. Electrodes that are strategically placed deliver electrical current to specific muscles, which may help to increase range of motion.
- Pulsed short-wave diathermy. High-frequency electromagnetic radiation is a form of deep heating that does not overheat the skin and subcutaneous fat.
- Ultrasound. High-frequency sound waves are another form of deep heating that can help to increase range of motion.
- Whirlpools. A form of hydrotherapy, a whirlpool uses warm or cool water to treat all or part of the body.
- Hot and cold packs. These provide some pain relief, as well as increase range of motion.
- Paraffin bath. This is effective at heating the joints in hands and feet and helps to increase range of motion.