Continuous Passive Motion

Question 1

What is CPM?

Answer 1

Continuous Passive Motion

• refers to the use of a motorized device that allows for continuous passive motion at a joint within a protective, prescribed range
• often used post-operatively to promote healing and reduce adhesion formation.
• common joint sites: knees and shoulders

Question 2

What are the indications for CPM?

Answer 2

1. Open reduction internal fixation (ORIF) of an intra-articular fracture when fracture segments are stable
2. Capsulotomy
3. Arthrolysis
4. Arthroplasty/Arthrotomy
5. Tendon reconstruction
6. Burns
7. Synovectomy
8. Ligament reconstruction
9. Post diaphyseal and metaphyseal fractures
10. Drainage of acute specific arthritis

Question 3

What are the physiological effects of CPM?

Answer 3

1. Reduces adhesion formations
2. Stimulates biologic healing response of articular cartilage, tendon, ligament, skin and periarticular tissue
3. Joint manipulation/mobilization
4. Tissue lubrication
5. Secondary changes in vascularization
6. Reduction of edema

Question 4

What are the precaution for CPM?

Answer 4

1. Watch for mechanical irritation, excessive bleeding or swelling.
2. Use precise ranges of protected motion, proper positioning, and proper monitoring of CPM
3. Care must be taken not to irritate or injure newly repaired or reconstructed tissues
4. Monitor any vascular or sensory impairment that may be present.
5. Special consideration should be taken for neurovascular structures.
6. Protective ranges as prescribed by the surgeon must be followed
7. CPM instructions must be given to the patient and family
8. RN’s and other personnel should be oriented to the device
9. CPM parameters should not be changed except if the physician or therapist approves it
10. Show pt the safety “kill” switch
11. provide pt. with technical service number for assistance

Question 5

What are contraindications for CPM?

Answer 5

1. Unstable fracture
2. Active infection
3. Confused restless patient

Question 6

What are the current usage recommendations for CPM?

Answer 6

• immediate post-op application
• 8-24 hour dosage; might be continous or 1-2 hours at a time
• within pain free and protective ROM
• duration: 1-3 weeks

Question 7

What adjustments can be made to a CPM unit?

Answer 7

Range, speed, and time

Question 8

What does CPM not replace?

Answer 8

active exercise