Continuous Passive Motion

Question 1

continuous passive motion (CPM)

Answer 1

electrical motorized devices that move joints through a preset partial PROM at a preset controlled speed

Question 2

Goal of CPM

Answer 2

prevent or decrease the negative effects of immobilization
in theory, CPM
- improve tissue healing (especially articular pathologies)
- prevent contractures
- delay atrophy

Question 3

Most common uses

Answer 3

• acute / subacute phase following
  
  • ACL reconstruction
  • TKA
  • CMP or osteochondral defects
• shoulder surgeries
• hand surgeries
• foot and ankle surgeries

Question 4

Theoretical Effects

Answer 4

• constant, light stress applied to injured tissue promotes natural alignment of collagen fibers and prevents cross linkages
• may assist in gaining ROM early in rehab (but no long term effects when compared to normal ROM exercises)
• may assist pt apprehension to ROM early in rehab since patient can predetermine ROM
• may decrease need of manip following TKA
• JOINT NUTRITION: more ROM
• -> circulates synovial fluids
• -> more effective than AROM for meniscal/cartilage repair
• EDEMA REDUCTION: assists in venous and lymphatic return
• PAIN REDUCTION: gentle movement activates sensory afferents to control pain through gate control theory (BUT pain meds still on board so we don’t know for sure)
• LIGAMENT HEALING: promotes more natural alignment of collagen fibers

Question 5

Indications

Answer 5

• TKA or other joint arthroplasty
• ACL reconstruction
• osteochondral repair
• chondromalacia surgery
• joint contractures
• tendon lacerations, esp in hand

Question 6

Contraindications

Answer 6

• unstable fractures
• conditions where CPM causes UNWANTED motion
• uncontrolled infection

Question 7

Treatment Protocols

Answer 7

Duration usually 1 hour, 3-4 / day

• long term bouts
• 6-8 hrs / day post surgery