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Continuous Passive Motion: Skate Board/Powder Board
Continuous Passive Motion: Skate Board/Powder Board
Benefits of CPM
CPM has been reported to be effective in lessening the negative
effects of joint immobilization in conditions such as
arthritis, contractures, and intra-articular fractures; it has also
improved the recovery rate and ROM after a variety of surgical
procedures.13,17,20-25,27 Basic research and clinical studies
reported by Salter have demonstrated the effectiveness of
CPM in a number of areas.
Prevents development of adhesions and contractures and
thus joint stiffness
Provides a stimulating effect on the healing of tendons and
ligaments
Enhances healing of incisions over the moving joint
Increases synovial fluid lubrication of the joint and thus
increases the rate of intra-articular cartilage healing and
regeneration
Prevents the degrading effects of immobilization
Provides a quicker return of ROM
Decreases postoperative pain
FOCUS ON EVIDENCE
Various studies have compared short and long-term outcomes
of CPM use after various types of surgery using
various parameters as well as CPM with other methods of
early movement and positioning.1,5,6,11,12,17-19,28,30 Some
studies have shown no significant difference between patients
undergoing CPM and those undergoing PROM or other
forms of early motion.5,11,12,19,29 Many studies support
the short-term benefits of CPM use after surgery in that
patients gain ROM more quickly and, therefore, may experience
earlier discharge from the hospital when CPM is
used compared with other forms of intervention. However,
long-term functional gains are reported to be no different
from those in patients who underwent other forms of early
motion.4,28,30
The authors of a Cochrane Review of 14 randomized controlled
trials in which CPM was used following total knee
arthroplasty summarized that for patients who had CPM
combined with physical therapy, there was a significant increase
in active knee flexion and decrease in length of hospital
stay as well as a decreased need for post-operative manipulation
compared to those receiving physical therapy alone.
There was no significant difference in passive knee flexion or
passive or active knee extension.14a
Some studies have identified detrimental effects, such as
the need for greater analgesic intervention and increased
postoperative blood drainage, when using CPM18,29 in
contrast to claims that CPM decreases postoperative pain
and postoperative complications.21-25,27 Cost-effectiveness
of the CPM equipment, patient compliance, utilization
and supervision of equipment by trained personnel, length
of hospital stay, speed of recovery, and determination of
appropriate patient populations become issues to consider
when making the choice of whether or not to utilize CPM
devices.12,15