Introduction
Joint contractures are common complications of nervous system diseases,
such as stroke and spinal cord injury,1 and more than
one-fifth (22.0%) of elderly residents in long-term care (LTC)
facilities suffer from joint contractures,2 resulting
in functional restrictions and limitations of joint mobility and thus
activity limitations and participation
restrictions.2-4 Many studies have noted that activity
limitations and participation restrictions, such as the inability to
write or inability to visit friends, are most relevant to patients with
joint contractures.5,6
Unfortunately, activity limitations and participation restrictions are
closely related to the quality of life (QOL) of elderly residents in LTC
facilities.7 Many experts even believe that QOL is an
important outcome indicator for elderly residents in LTC
facilities.8,9 Recent studies have examined the
explanatory power of various factors on the QOL of elderly residents in
LTC facilities and have found that activity and participation have the
best explanatory power (52.1%) on the QOL of elderly residents in LTC
facilities.10 This finding can help scholars and
experts concerned about the QOL of elderly residents in LTC facilities
to simplify the complex QOL connotation. Therefore, elderly individuals
with joint contractures may have severely limited mobility, which could
lead to participation restrictions and negatively affect their
QOL.5-7,11
Currently, the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) is a
widely used scale for the global assessment of activity and
participation; however, the scale has several issues. First, the
population is heterogeneous. Both the individuals who are frail but
still able to walk and the individuals who are severely constrained by
mobility are included. Second, affected individuals have different
preferences in terms of participation. Third, individuals may already
have one or more fully developed joint contractures or are at risk of
developing joint contractures. Fourth, personal life situations are
diverse, including different nursing care and assistance
resources.12 However, the WHODAS 2.0 is deigned to be
applicable to all health conditions, including diseases, illnesses,
injuries, mental or emotional problems, and alcohol or drug abuse. It
does not attempt to assign aetiology or apportion impairment or
disability to any particular disorder.13 The
evaluation of activity and participation is complex, and the complex
personal experience of impaired individuals must be
acknowledged.12 Therefore, an outcome questionnaire
that quantifies the activity and participation of a particular
population is particularly important. Thus far, no universally accepted
scale can address the abovementioned key issues.12However, the International Classification of Functioning, Disability,
and Health (ICF) is the common basis of the WHO’s patient-centred
measures and intervention plan and comprehensively classifies all health
and health-related fields.5 Therefore, the PaArticular
Scales, developed using the ICF as a standard, can fill this gap. The
purpose of this study was to examine the psychometric properties of the
Chinese version of the PaArticular Scales in joint contractures
population.