Incidence and predictors of early ankle contracture in adults with acquired brain injury
- Author:
Norhamizan Hamzah
;
Muhammad Aizuddin Bahari
;
Saini Jeffery Freddy Abdullah
;
Mazlina Mazlan
- Publication Type:Review
- MeSH:
Contracture;
Ankle
- From:Neurology Asia
2015;20(1):49-58
- CountryMalaysia
- Language:English
-
Abstract:
Objective: To determine the incidence and predictors of early ankle contracture in adults with acquired
brain injury. Methods: A prospective cohort study of patients admitted to Neurosurgical Intensive Care
Unit (NICU), University Malaya Medical Centre and referred for rehabilitation within a period of 12
months. Adult patients with newly diagnosed acquired brain injury with no prior deformity to lower
limbs, Glasgow Coma Scale ≤ 12, no concomitant spinal or lower limb injuries, medical stability at
inclusion into the study and agreed to participate for the total duration of assessment (3 months) were
recruited. We conducted weekly review of ankle muscle tone and measurement of ankle maximum
passive dorsiflexion motion. The end point is reached if ankle contracture developed or completed 3
months post injury assessment. Results: The cohort included 70 patients, of which only 46 patients
completed the study. Twenty-eight patients suffered from severe brain injury whilst 18 from moderate
brain injury. Out of the 46 patients, 13 (28%) developed ankle contracture at the end of the study period.
Abnormal motor pattern was significantly associated with incidence of ankle contracture, which included
spasticity (p<0.001), spastic dystonia (p=0.001) and clonus (p=0.015). Using univariate analysis, the
predictors for ankle contracture were spasticity (OR 51.67, CI 7.53-354.52, p<0.001), spastic dystonia
(OR 27.43 CI 2.84-265.35, p=0.004) and clonus (OR 4.18 CI 1.33-13.19, p =0.015).
Conclusion: Abnormal motor patterns are strongly associated with early incidence of ankle contracture
amongst adult with new diagnosis of moderate to severe acquired brain injury despite a regular
standard therapy program. This is an important clinical finding towards early prevention of ankle
contracture.
- Full text:P020150623405561021116.pdf
