| Overview | | | | development. |
| Continuous passive motion (CPM) is one of the | | | | The use of CPM |
| primary methods for decreasing the deleterious | | | | Applied postoperatively, this device may be used on |
| effects of immobilization and can deliver orthopedic, | | | | an inpatient or an outpatient basis. By using a |
| neurological, and even circulatory benefits to the | | | | motorized device to very gradually move the joint, it |
| patient. Immobilization, in turn, can create deleterious | | | | is possible to significantly accelerate recovery time by |
| sequelae of physiological and functional impairments. | | | | decreasing soft tissue stiffness,increasing range of |
| CPM is used following various types of reconstructive | | | | motion, promoting healing of joint surfaces and soft |
| joint surgery such as knee replacement and ACL | | | | tissue, and preventing the development of |
| reconstruction. Its mechanisms of action for aiding | | | | motion-limiting adhesions (scar tissue). Interestingly, |
| joint recovery are dependent upon what surgery is | | | | this is accomplished without patient effort (passively) |
| performed. One mechanism is the movement of | | | | as the machine moves ajoint through a defined |
| synovial fluid to allow for better diffusion of nutrients | | | | (prescribed) range of motion for an extended period |
| into damaged cartilage (which would be unimportant | | | | of time. Even more surprisingly, studies have shown |
| in the event of joint replacement), and diffusion of | | | | that patients using CPM devices require less pain |
| other materials out; such as blood and metabolic | | | | medication then patients who have had the same |
| waste products. Another mechanism is the | | | | type of surgery and are notusing this device. |
| prevention of fibrous scar tissue formation in the | | | | Within 24 hours of surgery your doctor can initiate |
| joint, which tends to decrease the range of motion | | | | the CPM machine.The machine will be used on your |
| for a joint. The concept was created by Robert B. | | | | new knee at least 4 hours during the day and all |
| Salter M.D in 1970 and, along with help from engineer | | | | night. You will continue this program when you go |
| John Saringer, a device was created in 1978. | | | | home. |
| CPM evolved over the course of several decades, | | | | The fuction of CPM |
| and is based on deductions that the inventor | | | | CPM would accelerate the healing of articular cartilage |
| formulated through clinical observation and practice. | | | | and periarticular structures, such as the joint capsule, |
| The first of these is that prolonged immobilization of | | | | ligaments, and tendons. CPM would decrease the |
| synovial joints causes many problems, including | | | | likelihood of joint contractures, therefore maintaining |
| persistent stiffness and pain, muscle atrophy, disuse | | | | the range of motion(ROM) achieved during surgery. |
| osteoporosis, and eventually degenerative arthritis | | | | CPM has been shown to significantly increase venous |
| when the joints are actively mobilized at a later time. | | | | flow over active and passive ankle dorsiflexion, |
| Second, beneficial effects of early active motion | | | | pneumatic compression, and manual calf |
| were seen clinically, such as decreased edema, | | | | compressions. The CPM machine has many |
| decreased pain, and shorter rehabilitation time. | | | | advantages. The machine administers controlled, |
| Finally, observations of cardiac surgery wherein the | | | | passive motion, which increases blood flow to the |
| heart muscle heals properly in the presence of | | | | joint. The increased blood brings nutrition to the joint, |
| constant motion, and in the costovertebral joints, | | | | and helps to alleviate swelling.The CPM machine |
| where constant motion occurs throughout the life of | | | | increases flexibility in the joint and shortens the time |
| the individual, yet where degenerative arthritis is | | | | of hospital stay. |
| rarely seen, led the inventor to pursue CPM | | | | |