Limb contractures are common impairments in selected progressive neuromuscular disease (NMD) conditions and can lead to such increased disabilities as worsening motor performance, decreased mobility, loss of ADL skills, and pain. Contracture is defined as the lack of full active or passive range of motion (ROM) due to joint, muscle, or soft tissue limitation. Contractures may be arthrogenic, soft tissue, or myogenic in nature, and a combination of intrinsic structural changes of muscle and extrinsic factors leads to myogenic contractures in selected neuromuscular disease conditions. These factors include the following:

• Degree of Fibrosis and Fatty Tissue Infiltration.
• Static Positioning and Lack of Full Active and Passive Range of Motion
• Imbalance of Agonist and Antagonist Muscle Strength Across the Joint.
• Lack of Upright Weight Bearing and Static Positioning in Sitting.
• Compensatory Postural Changes Used to Biomechanically Stabilize Joints for Upright Standing
• Functional Anatomy of Muscles and Joints

MANAGEMENT OF CONTRACTURES
Contractures in progressive NMD conditions should be managed with the following concepts in mind:
1. Prevention of contractures requires early diagnosis and initiation of physical medicine approaches such as passive ROM and splinting while contractures are still mild.
2. Contractures are inevitable in some NMD conditions, such as DMD.
3. Advanced contractures become fixed and show little response to stretching programs.
4. A major rationale for controlling contractures of the lower extremity is to minimize the adverse effect of contractures on independent ambulation. However, the major cause of wheelchair reliance in NMD is generally weakness, not contracture formation.
5. Static positioning of both upper and lower extremity joints in patients with weak musculature is the most important cause of contracture formation.
6. Passive stretching for control of lower limb contractures is most successful in ambulatory patients with early mild joint contractures.
7. Upper extremity contractures may not negatively impact function if they are mild.
8. Joint range of motion should be monitored regularly by physical therapists and occupational therapists using objective goniometric measurement.

International Journal of Physical Medicine & Rehabilitation welcomes research articles, review articles, methodologies, commentaries, case reports, perspectives and short communications encompassing all aspects of Physical Medicine & Rehabilitation. This journal provides latest developments in theoretical, experimental and clinical investigations in physical Medicine & Rehabilitation for Physiatrists and Rehabilitation researches.

This peer reviewed journal includes following topics but are not limited to: acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, amputation, prosthetics and orthotics, mobility, gait, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis studies, etc.

Contributions across the globe from all types of professions in rehabilitation are therefore encouraged. The editorial office of the journal promises a peer review process for the submitted manuscripts for the quality of publishing.

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Thanks and Regards
Editorial Team
International Journal of Physical Medicine & Rehabilitation