What is a contracture?

A contracture refers to the shortening of muscles and tendons caused by muscle inactivity or severe muscle tension (spasticity). Both causes are possible in ALS and are a common problem. Contractures typically develop in the hands, the elbow joint, and the shoulder joint, and most often affect flexor function. The hands are “clenched,” the elbow is fixed in a flexed position, or the arm is pressed against the torso. In the lower extremities, a plantar flexion posture predominates, resulting from shortening of the Achilles tendon and other muscle groups.

Intensive physical therapy or the use of therapeutic exercise equipment aims to prevent contractures or at least reduce their severity. Orthoses (from ancient Greek: “upright”) are devices used to stabilize and position the extremities and the trunk. These devices can also help prevent or treat contractures. In certain cases, specific orthoses (regression orthoses) can be used to “stretch” and reduce existing contractures. Therapy tables and electric wheelchairs with a standing function can also help reduce the frequency and severity of contractures.