Hi Ritchie

Here is the results of a PEDro search on contractures:

PEDro - Selected Search Results

You may find some good research-based methods here for preventing contractures in your unit.

Some points I have got out of looking at the literature and from my own practice:

There is some evidence out their that positioning does help prevent contractures. However the stimulus has to be quite high and sustainted - effective positioning often therefore means splinting.

Passive movements are probably not enough to prevent contractures

It seems to be all about preventing and not treating. Once contractures have formed it is really hard to change. Musculo-tendinous units may not be very mutable to lengthening once shortening has occurred and the evidence that stretching can help appears rather floored (Harvey, Batty, Crosbie, Poulter, & Herbert, 2000). So yes this is a really important issue you are asking about.

Ref: Harvey, L. A., Batty, J., Crosbie, J., Poulter, S., & Herbert, R. D. (2000). A randomized trial assessing the effects of 4 weeks of daily stretching on ankle mobility in patients with spinal cord injuries. Arch Phys Med Rehabil, 81(10), 1340-1347.

Hope this is of help