From range of motion to function: Loss of joint flexibility after burns: when is it a problem?

Anouk Oosterwijk

    Research output: ThesisThesis fully internal (DIV)

    292 Downloads (Pure)


    To perform daily activities, sufficient flexibility in all joints with associated movement directions is required. Unfortunately, loss of flexibility in one or more movement directions of a joint is a well-known complication after various diseases, including burns. In burns, scar contractures limit flexibility. It should be mentioned however, that getting insight in the prevalence, course and severity of scar contractures is complicated by the fact that the definition of the construct ‘contractures’ is not yet unambiguous. So far, a contracture is defined as diminished flexibility and operationalized as a range of motion (ROM) lower than the corresponding norm ROM. However, the significance of loss of flexibility lies in its limitation of function, while function is not included in this definition.
    In this thesis the use of norm ROM for the operationalisation of problems with flexibility is challenged by a more functional approach to the construct ‘contracture’. Therefore, the term ‘functional ROM’ is introduced and operationalized as the critical joint angles where a patient’s natural performance of one or more daily tasks is hampered.
    The most important finding of this thesis is that the impact of a certain degree of ROM loss on the capacity to naturally perform daily tasks differs per joint and movement direction. This implies that analysing ROM loss for all joints the same way, like with the norm ROM-method or its derivatives, is not viable to determine functional outcomes. The functional ROM-method is therefore recommended.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    • van der Schans, Cornelis, Supervisor
    • Mouton, Noor, Co-supervisor
    • Nieuwenhuis, Marianne, Co-supervisor
    Award date16-Sept-2020
    Place of Publication[Groningen]
    Print ISBNs978-94-034-2803-1
    Electronic ISBNs978-94-034-2804-8
    Publication statusPublished - 2020

    Cite this