Continuous Passive Motion in the Rehabilitation Setting

Nadler, Scott F.; Malanga, Gerard A.; Zimmerman, Jerald R.

doi:10.1097/00002060-199306000-00011

Cited by 33 publications

(21 citation statements)

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“…Our results concur with other investigators who measured flexion at discharge and did not begin CPM use immediately following total knee arthroplasty surgery (9. 16,17,19,27,29). Yet, there is also extensive documentation suggesting that CPM does increase a total knee arthroplasty patient's flexion.…”

Section: Cpm Duration and Rom Incrementmentioning

confidence: 99%

“…The rate at which ROM is achieved, as reported by Basso and Knapp ( I ) , may be a more appropriate criterion since this outcome encompasses both time frame and ROM. It is interesting to note that ROM in total knee arthroplasty patients appears to be equalized over time regardless of CPM use (2, 13,16,21,27). Thus, it I t appears that the benefit of using continuous passive motion to improve the rate of change of flexion probably occurs early in the postoperative course.…”

Section: Cpm Duration and Rom Incrementmentioning

confidence: 99%

“…We express our profound gratitude to all the staff physical therapists at Columbia Presbyterian Medical 16, 1992 …”

Section: Acknowledgmentsmentioning

confidence: 99%

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The Effect of Continuous Passive Motion Duration and Increment on Range of Motion in Total Knee Arthroplasty Patients

Chiarello

Gundersen²,

O'Halloran³

1997

J Orthop Sports Phys Ther

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ontinuous passive motion (CPM) is a machinedependent rnodality in which an external motorized device moves the limb through a pre-set arc of m e tion ( 1 0). The biologic concept of CPM was originated by Salter to provide optimal conditions for the healing and regeneration of articular cartilage (22). From his clinical observations on the value of early active motion and the deleterious effects of prolonged immobilization, Salter developed a CPM machine, which was used in a series of animal experiments. In rabbits treated with immediate postoperative CPM, Salter demonstrated enhanced healing of cartilage which grossly, histologically, and biochemically resembled articular cartilage with a predominance of type I1 collagen (24). In addition, CPM improved wound healing (22). accelerated clearance of hemarthrosis (18), and prevented cartilage degeneration in septic arthritis (23).Coutts, who initiated the use of CPM on total knee arthroplasty patients, believes that CPM modulates the process of postoperative scarring that interferes with restoration of joint motion (3,4,7). During normal healing, collagen fibers grow in a random fiber orientation, producing resistance to free movement. Thus, Coutts and Coutts et al contend that CPM enhances the restoration of Arthroplasty patients There is insufficient information on continuous passive motion (CPM) parameters in total

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Section: Cpm Duration and Rom Incrementmentioning

confidence: 99%

Section: Cpm Duration and Rom Incrementmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Continuous Passive Motion Duration and Increment on Range of Motion in Total Knee Arthroplasty Patients

Chiarello

Gundersen²,

O'Halloran³

1997

J Orthop Sports Phys Ther

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“…Some trials have shown that early postoperative knee ROM is improved with the addition of CPM, [5][6][7][8][9][10][11] whereas other studies have demonstrated no difference. [12][13][14][15][16][17] The variability seen with these results is, in our view, most likely the result of variation in the postoperative CPM protocols, sample sizes, and rigor of study design. The investigators in these studies, however, all concluded that the use of CPM did not affect the long-term knee ROM attained by 6 months after the operation.…”

mentioning

confidence: 99%

Exercise Combined With Continuous Passive Motion or Slider Board Therapy Compared With Exercise Only: A Randomized Controlled Trial of Patients Following Total Knee Arthroplasty

Beaupré

Davies

Jones³

et al. 2001

Physical Therapy

114

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Background and Purpose. The primary purpose of this randomized controlled trial was to determine which method of mobilization-(1) standardized exercises (SE) and continuous passive motion (CPM), (2) SE and slider board (SB) therapy, using an inexpensive, nontechnical device that requires minimal knee active range of motion (ROM), or (3) SE alone-achieved the maximum degree of knee ROM in the first 6 months following primary total knee arthroplasty (TKA). The secondary purpose was to compare health-related quality of life among these 3 groups. Subjects. The subjects were 120 patients (nϭ40/group) who received a TKA at a teaching hospital between June 1997 and July 1998 and who agreed to participate in the study. Methods. Subjects were examined preoperatively, at discharge, and at 3 and 6 months after surgery. The examination consisted of measurement of knee ROM and completion of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results. The 3 treatment groups were similar with respect to age, sex, and diagnosis at the start of the study. There were no differences in knee ROM or in WOMAC Osteoarthritis Index or SF-36 scores at any of the measurement intervals. The rate of postoperative complications also was not different among the groups. Discussion and Conclusion. When postoperative rehabilitation regimens that focus on early mobilization of the patient are used, adjunct ROM therapies (CPM and SB) that are added to daily SE sessions are not required. Six months after TKA, patients attain a satisfactory level of knee ROM and function. [Beaupré LA, Davies DM, Jones CA, Cinats JG. Exercise combined with continuous passive motion or slider board therapy compared with exercise only: a randomized controlled trial of patients following total knee arthroplasty.

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“…CPM did not affect the long-term knee ROM attained by 6 months 14 or a year 15 after the operation. Some studies have shown that early pro-operative knee range of motion (ROM) improves the functional results where as other studies have demonstrated no difference 16 .…”

Section: The Biomechanical Importance Ofmentioning

confidence: 99%

Annual Seminar of Hellenic Osteoporosis Foundation The role of mechanical factors on the musculoskeletal system

Zidrou¹,

Potoupnis²,

Karponis³

et al. 2016

JFSF

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The cellular activities of bone modeling and remodeling determine the material composition and structure of bone. Bone modeling refers to the deposition of new bone without prior bone resorption. Bone remodeling is characterized by the appearance of focally and temporally distinct regions of resorption followed by bone formation that constitutes the basic multicellular units (BMUs).The purpose of bone modeling and remodeling during growth is to build peak bone strength. After the completion of growth, bone modeling continues in adulthood modestly to increase bone size further, whereas bone remodeling maintains bone strength by removal of microdamage.The concept of peak bone mass more broadly captures peak bone strength, which is characterized by mass, density, microarchitecture, microrepair mechanisms and the geometric properties that provide structural strength. If the magnitude of peak bone mass attained in young adulthood is an important predictor of osteoporosis later in life, then the timing of peak bone mass is also important because it defines the lifecycle phase during which peak bone mass can be optimized Although bone mineral density (BMD) is among the strongest risk factors for fracture, a number of clinical studies have demonstrated the limitations of bone mineral density measurements in assessing fracture risk and monitoring the response to the therapy. These observations have brought renewed attention to the broader array of factors that influence skeletal fragility, including bone size, shape, microarchitecture and bone quality. Bone fragility can be defined by biomechanical parameters, including ultimate force, ultimate displacement and energy absorption.The biomechanical definition of bone fragility includes at least three components: strength, brittleness and work to failure. A fourth biomechanical measure, stiffness, also is used to assess mechanical integrity of bones, but is not a direct measure of fragility. There are at least three ways to make the skeleton stronger. First, increase bone masslarger bones can carry more load. Second, distribute bone mass effectively, i.e. put bone tissue where the mechanical demand are greatest. Third, improve the material properties of bone tissue such that the bone is stronger at a tissue-level.The causes of bone fragility are: abnormal collagen (Osteogenesis imperfecta, Paget's disease of bone), mineralization defect (osteomalacia), abnormal remodeling rate and balance (turnover) [A. High bone turnover with negative BMU balance-postmenopausal osteoporosis, hyperparathyroidism, B. Other abnormalities of bone turnover with negative BMU balance-osteoporosis in men, corticosteroid-induced osteoporosis]The genetic basis of osteoporosis has been difficult to identify. Nevertheless, several approaches have been undertaken in the past decades in order to identify candidate genes for bone fragility, including the study of rare monogenic syndromes with striking phenotypes (Osteogenesis imperfecta and osteopetrosis), the analysis of individuals or families with ext...

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Continuous Passive Motion in the Rehabilitation Setting

Cited by 33 publications

References 0 publications

The Effect of Continuous Passive Motion Duration and Increment on Range of Motion in Total Knee Arthroplasty Patients

The Effect of Continuous Passive Motion Duration and Increment on Range of Motion in Total Knee Arthroplasty Patients

Exercise Combined With Continuous Passive Motion or Slider Board Therapy Compared With Exercise Only: A Randomized Controlled Trial of Patients Following Total Knee Arthroplasty

Annual Seminar of Hellenic Osteoporosis Foundation The role of mechanical factors on the musculoskeletal system

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