How often and why joint contractures develop in mechanically ventilated ICU patients

Incidence and Determinants of Joint Contractures in Mechanically Ventilated Intensive Care Unit Patients: a Prospective Cohort Study

This project will follow mechanically ventilated adults in the ICU to see how often they develop joint contractures and which ICU-related factors are linked to that risk.

Quick facts

• Study type: Observational
• Enrollment: 150 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Elazıg Fethi Sekin Sehir Hastanesi (other)
• Locations: 1 site (Elâzığ, Elaziğ)
• Trial ID: NCT07339397 on ClinicalTrials.gov

What this trial studies

This is a prospective, non-interventional cohort conducted in a tertiary-level ICU enrolling adults who are mechanically ventilated, immobilized, and have impaired consciousness. Patients are enrolled within 48 hours of ICU admission and followed throughout their stay, with passive range of motion (PROM) measured twice weekly using a goniometer by trained assessors. Joint contracture is defined as a ≥33% reduction in passive joint range of motion compared with normal reference values, and individuals with pre-existing contractures, amputations, neuromuscular disease, or conditions preventing safe assessment are excluded. All participants receive routine ICU care and physiotherapy, and the study will analyze clinical and ICU-related factors associated with new contracture development.

Who should consider this trial

Good fit: Adults (≥18 years) who are mechanically ventilated, immobilized in the ICU for at least seven days, have impaired consciousness (GCS ≤10), and for whom consent can be provided by a legal representative.

Not a fit: Patients with pre-existing joint contractures, ankylosis, amputations, neuromuscular disease or spasticity, recent prolonged pre-admission immobilization, or unstable hemodynamics are excluded and unlikely to benefit.

Why it matters

Potential benefit: If successful, the findings could help clinicians identify high-risk patients and refine early mobility and physiotherapy practices to reduce post-ICU disability from contractures.

How similar studies have performed: Previous research has linked prolonged immobilization, deep sedation, and neuromuscular blockade to musculoskeletal complications and ICU-acquired weakness, but few prospective cohorts have systematically measured PROM and contracture incidence, so this approach builds on known risks while addressing a relatively under-studied outcome.

Eligibility criteria

Inclusion Criteria:

* • Adult patients aged 18 and over

  * Patients on mechanical ventilation and monitored in the intensive care unit for at least 7 days
  * Glasgow Coma Score ≤10
  * Patients monitored immobile in the intensive care unit
  * Situations where informed consent can be obtained from the patient's legal representative

Exclusion Criteria:

* • Presence of pre-existing joint contracture, ankylosis, or amputation

  * Patients with severe burns, fractures, or surgical reasons preventing joint movement
  * Patients with a history of neuromuscular disease or spasticity
  * Patients who were immobilized for ≥1 week prior to admission to the intensive care unit
  * Hemodynamic instability situations where measurement is unreliable

Where this trial is running

Elâzığ, Elaziğ

• Fethi Sekin City Hospital — Elâzığ, Elaziğ, Turkey (Türkiye) (RECRUITING)

Study contacts

• Study coordinator: Sevim F Şenol Karataş, MD, PhD

Conditions: Joint Contractures, Critical Illness, Mechanical Ventilation, INTANSIVE CARE, Joint contracture, Intensive care unit, Mechanical ventilation, Passive range of motion