A Controlled Evaluation of Continuous Motion in Patients Undergoing Total Knee Arthroplasty

McInnes, J M; Larson, Martin G.; Daltroy, Lawren H.; Brown, Tony; Fossel, Anne H.; Eaton, Holley M.; Shulman-Kirwan, B.; Steindorf, S; Poss, Robert; Liang, Matthew H.

doi:10.1097/00132586-199304000-00052

Cited by 4 publications

(13 citation statements)

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“…Quadriceps' strength levels at 4 days after surgery were much higher in this study than in the study reported by McInnes et al 10 This apparent difference could be due to the fact that we measured strength at about 60°of flexion, whereas they measured at 45°of flexion. However, McInnes and colleagues did not find any significant differences in strength, whereas we found a difference of 50% between the CPM and control groups.…”

Section: Secondary Measures Of Effectcontrasting

confidence: 85%

“…A possible explanation for the difference in strength between the two groups could be the fact that CPM is not as 'passive' a treatment as we think it is, and may involve muscular activity while 'resting' in the machine. Why we found a large difference whereas McInnes et al 10 reported no difference remains unclear. The effect on pain was also markedly greater than that reported by previous studies.…”

Section: Secondary Measures Of Effectcontrasting

confidence: 59%

“…Major outcome measures were mobility, which was assessed in all 12 trials, length of hospital stay, assessed in five, 5,10,11,14,15 and drain production, assessed in four. 7,[14][15][16] Overall, there seem to be short-term beneficial effects on mobility.…”

mentioning

confidence: 99%

“…Of six studies measuring mobility within the first 2 weeks after the operation, five reported positive effects of CPM. 3,7,[9][10][11]15 Reported differences between CPM and control groups range from -1°to +18°in favour of the CPM group. The functional consequences of faster mobility improvement remain unclear, however, and in the long term there do not seem to be advantages to the use of CPM.…”

mentioning

confidence: 99%

“…The formerly common fortnight's hospital stay has gradually been reduced to 4-5 days, and 1 week of bed rest has been replaced by mobilisation of the patients starting on the first or second day after the operation. 7,9,10,15 These protocol changes raise the question whether the effects on CPM reported in relation to the older protocols are still valid. Rehabilitation now starts on the first day after surgery, resulting in activity during the first two stages of connective tissue repair.…”

mentioning

confidence: 99%

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Continuous Passive Motion (CPM) in Rehabilitation Following Total Knee Arthroplasty: A Randomised Controlled Trial

Lenssen¹,

Bie²,

Bulstra³

et al. 2003

Physical Therapy Reviews

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Section: Secondary Measures Of Effectcontrasting

confidence: 85%

Section: Secondary Measures Of Effectcontrasting

confidence: 59%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Continuous Passive Motion (CPM) in Rehabilitation Following Total Knee Arthroplasty: A Randomised Controlled Trial

Lenssen¹,

Bie²,

Bulstra³

et al. 2003

Physical Therapy Reviews

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Continuous passive motion following total knee replacement: a prospective randomized trial with follow-up to 1 year

Leach

Reid

Murphy

2006

Knee Surg Sports Traumatol Arthrosc

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We have carried out a prospective randomised, single blind clinical trial to investigate the effect of continuous passive motion on range of knee flexion, lack of extension, pain levels and analgesic use after total knee replacement surgery. 85 subjects were randomly allocated to control or study group. All subjects followed the existing rehabilitation protocol, which permits immediate active range of motion exercises and mobilisation with the study group using continuous passive motion for 1 h, twice a day. Outcome measures employed were range of motion, pain assessed on a visual analogue scale and analgesic use according to the WHO ladder. Blinded evaluation was carried out preoperatively, at time of discharge from hospital, 6 weeks, 6 and 12 months postoperation. No significant difference was observed between groups at all time intervals for each outcome variable using Wilcoxon Rank sum tests. The results substantiate previous findings that short duration continuous passive motion following total knee arthroplasty does not influence outcome of range of motion or reported pain.

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Continuous Passive Motion Following Primary Total Knee Arthroplasty:short- and Long-term Effects on Range of Motion

Lenssen¹,

Köke²,

Bie³

et al. 2003

Physical Therapy Reviews

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BACKGROUNDTotal knee arthroplasty (TKA) is a common form of orthopaedic surgery, mostly in osteoarthritis patients.Since patients undergoing joint arthroplasty are discharged from the hospital within 1-2 weeks after the operation, the main targets of rehabilitation are rapid mobilisation of the patient and early regaining of the ABSTRACT Study design: a systematic review of randomised controlled trials. Background: Knee arthroplasties are a common surgical procedure for patients suffering from knee osteoarthritis. Continuous passive motion (CPM) is frequently used to increase range of motion (ROM) in the knee and promote rapid postoperative recovery of patients undergoing total knee arthroplasty (TKA). Many clinical trials have tried to assess its efficacy, but results have been contradictory. Objectives: To review the efficacy in terms of ROM of CPM in the postoperative management of patients undergoing TKA. Methods: Medline, Embase, Cinahl and Cochrane databases and bibliographic indexes and relevant citations were searched. All relevant studies were assessed for methodological quality using a validated scoring instrument. Data collection and analysis: Two reviewers independently extracted data and assessed trial quality. Results of a meta-analysis of ROM data were divided into short-term effects (i.e. 7-14 days after surgery) and long-term effects (i.e. 6-12 months after surgery). Where possible, data from individual trials were combined in a meta-analysis. Data were analysed using weighted mean differences (WMD with 95% confidence intervals [CI]) between treatment and control groups in the short and long term, weight being the inverse of variance. Main results: Fifteen studies investigating the effect of continuous passive motion in the management of TKA patients were included in the review. Study quality ranged from poor (2 points on a 10-point scale) to good (8 points). The evidence on the efficacy of CPM after TKA is conflicting. Positive short-term effects of adding CPM to standardised physical therapy (PT) have been reported on flexion ROM. Five studies were included in a pooled analysis, for a total of 317 patients (pooled effect size WMD 8.27; 95% CI -1.60, 18.15) Conclusions: There is evidence of a moderate positive, short-term effect of adding CPM to standardised PT after total knee arthroplasty. There is no relevant long-term effect of CPM use.

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A Controlled Evaluation of Continuous Motion in Patients Undergoing Total Knee Arthroplasty

Cited by 4 publications

References 0 publications

Continuous Passive Motion (CPM) in Rehabilitation Following Total Knee Arthroplasty: A Randomised Controlled Trial

Continuous Passive Motion (CPM) in Rehabilitation Following Total Knee Arthroplasty: A Randomised Controlled Trial

Continuous passive motion following total knee replacement: a prospective randomized trial with follow-up to 1 year

Continuous Passive Motion Following Primary Total Knee Arthroplasty:short- and Long-term Effects on Range of Motion

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