Passive movements for contractures

Contractures, a common complication following immobility, lead to restricted joint range of motion. Passive movements (PMs) are widely used for the treatment and prevention of contractures; however, it is not clear whether they are effective

Question

What systematic reviews are there on passive movements for contractures?

Identified literature

Table 1. Systematic reviews with low/medium risk of bias
Included studies Population/Intervention Outcome
Prabhu, et. al. 2013
2 randomised studies, a total of 122 participants with neurological conditions comparing passive movements versus no passive movements.
Both studies had a low risk of bias.
Participants with existing contractures or those at risk of developing contractures. Participants of either gender and of any age were included. Participants were included regardless of sensory or motor impairments and were separated according to their broad diagnostic groups.
Both studies investigated the effects of PMs in persons with neurological conditions. One study included people with spinal cord injury, and the other elderly people with paratonia.
Effect: Joint mobility, including measures of active or passive range of motion with or without standardised torques. Units of measure were expressed in degrees (degree per unit of torque or centimetre). Unidirectional and bidirectional range of motion measurements were included; and
Adverse effects: None reported. The aim was to include joint subluxations or dislocations, heterotopic ossification, autonomic dysreflexia (an exaggerated response of the sympathetic nervous system typically seen in people with spinal cord injury), fractures and muscle tears.
Authors' conclusion: “It is not clear whether passive movements are effective for the treatment and prevention of contractures.”
“The GRADE level of evidence showing the effects of Passive Movements on joint mobility, spasticity and pain is very low, primarily because of the paucity of studies in the area. Medium- and long-term effects of PMs on any outcome have not been investigated.”

References

  1. Prabhu RKR, Swaminathan N, Harvey LA.(2013) Passive movements for the treatment and prevention of contractures. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD009331. DOI: 10.1002/14651858.CD009331.pub2.

SBU Enquiry Service Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

Published: 5/6/2020
Contact SBU: registrator@sbu.se
Report no: ut202018
Registration no: SBU 2020/142