continuous passive movement

1. BY
ASS.PROF.DR. MOHAMED SERAG
DR. DOAA TAMMAM
Continuous passive motion
CPM

2. Definition :
Continuous passive motion
(CPM) is a treatment method
that help in recovery of joints
immediately after trauma or
surgery.

3.  CPM carried out by CPM device which
constantly move the joint through a
controlled ROM , the exact range is
dependent on the joint but in the most cases
the range of motion is increase over time.

4. - Mechanism of Action
 Mechanism of action to aid joint recovery depend
on what surgery is performed.
 1- movement of synovial fluid : to allow for
better diffusion of nutrients into damaged
cartilage and diffusion of blood and waste
products
 2- another mechanism: is the prevention of
fibrous scar tissue formation in the joint, which
tend to decrease the ROM for joint.

5.  CPM can be used clinically in post operative
rehabilitation and management:
 1-after ligament repair or other intra-
articular surgery
 2-internal fixation of fracture
 3-joint manipulation for contractures
 4-total joint replacement
Uses of CPM:

6. Clinical advantage of CPM
 1- Providing early motion
 2-achieving functional ROM
 3-Aid in pain relief
 4-improve general circulation
 5-reduce edema
 6-improve cartilage synovial fluid
 7-retard (delay)muscular atrophy
 8- stiffness
 9- incidence of complication
 10- reduce hospital stay
 11-enhance wound healing

7. Disadvantages:
 1- increased length of time spend in bed
limiting walking
 2- considerable maintenance costs
 3- Mismatching of the units due to different
leg sizes- shape
 4- CPM affected only the ROM and swelling
not muscular activity or power

8. Contraindication:
1- Unstable Fractures
2- Loss Of Sensation
3- Un Controlled Or Untreated Infection
Precautions:
Patients Can Complain As Result Of :
1- Inability To Apply Machine Properly
2- Lack Of Training For Nursing Or Therapist Who
Might Render Use Of Device a Risk To The Patient

9. Risks:
1- wound complication
2- disruption of surgical
measure such as ligament repair
3-malfunction of the device

10. CPM materials and functions:
 CPM device composed of 3 major parts:
 -Limb carrier
 - the motor
 - the controls
there are 3 variables to each subject:
 1- the size of motion arc
 2-the position of the motion arc in
relationship to normal arc of the joint
 3-the rate of motion

11. Characteristics of CPM unit:
 1- the device should fit anatomy to be moved as
closely as possible
 2-the axis and the quantity of motion should be as
close as possible to patients (the repaired joint and
perpendicular structures will then be protected
from adverse stress)
 3-the device should be adjustable in order to
increase or decrease the ROM within the
comfortable levels of the patient

12.  4- the machine must be designed to resist
fatigue during operation in the device
 5- the device must be easy to control easily
turned off and on by patients and easily
adjusted by physician.
 6- the device should be portable

13. Application
 1- therapist application of CPM device should be
within 72 hours following surgery.
 2- the device itself supports the limb and slowly
move the joint without patient assistance and move
through 24 hours.
 3- application of device is continued from 1- 4 weeks.

16. Evidence base
 Recent studies compare between long tem goal and
short term goal in using PROM and CPM:
 Studies observe that CPM most effective than
PROM in short term goal ( pain , swelling, and
start move early)
 But no difference between PROM and CPM in long
term goal

17. THANK YOU