Continuous Passive Motion (CPM) Devices
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Therapeutic rehabilitation of musculoskeletal injuries including post-surgical procedures is divided into three phases of rehabilitation:
- Phase 1 – Acute or Maximum Protection
- Phase 2 – Subacute or Moderate Protection
- Phase 3 – Chronic or Minimum Protection
During phase 1 the primary goals of treatment are:
- Control inflammation and pain
- Minimize the effects of immobilization
Rest, Ice, Compression, and Elevation (RICE) are the interventions to help control inflammation and pain. The primary intervention to “minimize the effects of immobilization” is passive range of motion (PROM). The detrimental effects of joint immobilization are cartilage degeneration, poor circulation, loss of range of motion and atrophy.
Continuous passive motion (CPM) devices, used almost immediately post-operative, provide passive (no work is being performed by the patient) motion in a specific range of motion. The motion gently bends and extends the joint to a set number of degrees and at a present speed.
This continuous motion helps with:
- Circulation – delivering oxygen rich blood to the affected area.
- Maintaining mobility – moving the joint/tissues through a controlled range of motion which increases in range over time
- Providing a pain relieving stimulus – by reducing stiffness and scar tissue formation
- Maintaining the integrity of the articular cartilage on the ends of the articulating bones - through the mechanical forces acting on the joint surfaces that produces a better diffusion of nutrients from synovial fluid into cartilage, and diffusion out of metabolic waste products.
CPM is mostly used on major joints like the knee, hip, and elbow, but adapting configurations can be used for other smaller joints. CPM is often recommended for procedures like total knee arthroplasty, ACL reconstruction, knee meniscal repair, and for those suffering with frozen shoulder syndrome.
There is some evidence that when used in conjunction with compressive devices or stockings, CPM can help reduce the risk of circulatory stasis and deep vein thrombosis (DVT).