Effektivität der postoperativen Behandlung mittels motorisierter Bewegungsschienen (CPM) bei Patienten mit Ruptur der Rotatorenmanschette

Abstract

The postoperative treatment of a total tear of the rotator cuff with a combined continuous passive motion and physiotherapy protocol provided a significantly earlier range of motion in the shoulder joint than physiotherapy alone. There was no report of CPM-related adverse effects.

The effectiveness of continuous passive motion on range of motion, pain and muscle strength following rotator cuff repair: a systematic review

“…This may be attributed to the natural phases of healing, as the majority of healing takes place between three and six weeks. 23 Although no statistically significant findings were noted by Michael et al 19 it is worth mentioning that pain experienced by patients treated with continuous passive motion plus physiotherapy was remarkably less than those treated with physiotherapy only.…”

“…13 Although LaStayo et al 18 found no statistically significant difference in range of motion between the intervention (continuous passive motion plus physiotherapy) and the control group (physiotherapy only), the fact that continuous passive motion was initiated more than three days post operatively, during which granulation tissue formation occurs, may have resulted in the early joint stiffness. 17,21 In contrast, the results of Michael et al 19 should be Continuous passive motion following rotator cuff repair 299 read with caution since the ratio between the number of participants in the intervention group (continuous passive motion plus physiotherapy) and control group (physiotherapy only) in their study was 2 : 1. This may explain why there was a greater improvement observed in the intervention group (continuous passive motion plus physiotherapy).…”

“…[17][18][19] If a study successfully met the criterion, a 'þ' was allocated; and if a study did not meet the criterion, a '0' was allocated. The results are represented in Table 1.…”

“…The detailed interventions for each study are tabulated in Table 3 and include the duration of the intervention. In the studies by Raab et al, 17 LaStayo et al 18 and Michael et al, 19 the control groups received the same therapy as the respective intervention groups, but without the use of continuous passive motion. The outcome measures used to assess range of motion, pain and muscle strength as well as the assessment intervals of each study have been summarized in Table 4.…”

“…LaStayo et al 18 found no statistical significant differences between the two groups with regards to muscle strength in external rotation (P 0.20 analysis of covariance). Certain criteria (strength) in the constant score in Michael et al 19 could not be evaluated as different clinics allowed initiation of a variety of active movements at different intervals post operatively. The different institutions did not go according to the advised after-treatment protocol.…”