A retrospective analysis of joint range of movement in people

Advances in medical sciences and technology have allowed more severely impaired people to survive, leading to an increase in the number of people with a disorder of consciousness (Royal College of Physicians, 2013). Disorders of consciousness are a group of disorders where the patients have no or very limited levels of consciousness. For the purposes of this project a patient in a Vegetative State (VS) or Minimally Conscious State (MCS) will be considered to be with a disorder of consciousness

Research questions:

• Does age and type of brain injury (traumatic or hypoxic) influence deterioration or improvement in joint range of movement or spinal deformity?
• Does a customised physical management programme (including 24-hr posture management in bed and wheelchair, static splinting and stretching) prevent deterioration in joint range of movement in people with prolonged Disorders of Consciousness?

 

Methodology:

Multidisciplinary clinical notes (comprising nursing, therapy and medical notes) of 20 patients who were/are resident at the unit between September 2005 and September 2016 will be used for data collection. Cause of DOC, age, range of movement (ROM) of all major joints, modified Ashworth Score (MAS) or Tardiue score, number of treatment sessions provided per month including details of the splinting regime and 24-hr posture management protocol were collected.

A convenience sample of all patients with a diagnosis of DOC admitted to the units between September 2005 and September 2016 were included. Standard statistical methods were used in analysis of data collected.

 

Relevance:

This study will inform the effects of physical management interventions (including 24-hr posture management) to many clinicians who are involved in delivering this treatment.

This retrospective review is expected to provide information that can be used to improve the standard of resource intensive treatments delivered to people with a disorder of consciousness, who may need this input throughout their lifetime.

 

• Lead Organisation: Holy Cross Hospital
• Funding body: Holy Cross Hospital
• Project contact details: 01428 643311

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