In 2000, Fox, et. al., conducted study about Knee contractures which pose a significant challenge in the care of older adults residing in long-term care facilities. Despite the importance of addressing contractures, limited research has been conducted to evaluate effective interventions. This study aimed to investigate the efficacy of a specialized bed positioning program (BPP) in treating knee flexion contractures among institutionalized patients.

Sixteen patients, characterized by a high level of cognitive and functional impairment, with a mean age of 82 years (SD=6.48, range=71-93), were recruited from a chronic care hospital to partake in this study.

The BPP involved stretching the patients’ knees into extension and maintaining the position for 40 minutes, four times a week. Participants were randomly divided into two groups (n=8 each). One group underwent the BPP for 8 weeks, followed by an 8-week period without intervention. The second group experienced the intervention in the reverse order. Weekly assessments were conducted, focusing on knee extension range, knee pain, and skin integrity.

Twelve participants successfully completed the study. Surprisingly, there was no observable improvement in the range of knee extension during the intervention period. Overall, the mean range of knee extension showed no significant difference between the intervention and no-intervention periods.

Contrary to expectations, the findings of this study do not provide support for the efficacy of the Bed Positioning Program in treating knee flexion contractures in older adults. While the small sample size and specific patient characteristics may have influenced the outcomes, these results suggest a need for further exploration of alternative interventions or modifications to existing protocols for managing knee contractures in institutionalized populations.

Reference: Fox, P., Richardson, J., McInnes, B., Tait, D., & Bedard, M. (2000). Effectiveness of a bed positioning program for treating older adults with knee contractures who are institutionalized. Physical therapy, 80(4), 363-372.